Healthcare Provider Details

I. General information

NPI: 1417726456
Provider Name (Legal Business Name): FULL SPHERE COUNSELING AND CONSULTING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2024
Last Update Date: 01/01/2024
Certification Date: 12/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 HERALD AVE
CINCINNATI OH
45207
US

IV. Provider business mailing address

8326 HAMBLETONIAN DR
CINCINNATI OH
45249-1308
US

V. Phone/Fax

Practice location:
  • Phone: 513-223-0767
  • Fax:
Mailing address:
  • Phone: 513-223-0767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN JAMISON
Title or Position: OWNER/PROVIDER
Credential: ED.D, LPCC, LSW
Phone: 513-223-0767