Healthcare Provider Details

I. General information

NPI: 1740165802
Provider Name (Legal Business Name): FULL CIRCLE CENTER FOR PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 W SUPERIOR ST STE 402
DULUTH MN
55802-1726
US

IV. Provider business mailing address

324 W SUPERIOR ST STE 402
DULUTH MN
55802-1726
US

V. Phone/Fax

Practice location:
  • Phone: 218-726-5433
  • Fax: 218-279-2844
Mailing address:
  • Phone: 218-726-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANINE JENSEN
Title or Position: THERAPIST
Credential: LPCC
Phone: 218-726-5433