Healthcare Provider Details

I. General information

NPI: 1114853900
Provider Name (Legal Business Name): FULL CIRCLE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11117 CANTER CIR
UPPER MARLBORO MD
20772-8357
US

IV. Provider business mailing address

11117 CANTER CIR
UPPER MARLBORO MD
20772-8357
US

V. Phone/Fax

Practice location:
  • Phone: 301-335-9638
  • Fax:
Mailing address:
  • Phone: 301-335-9638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NATALIE JAFFER
Title or Position: MANAGING MEMBER
Credential: APRN
Phone: 301-335-9638