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General NPI Number Information
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NPI Number | 1134600091
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Entity Type | Organization
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Legal Business Name | FULL CIRCLE MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 08/28/2018
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Provider Practice Location Address
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Address Line | 301 N FAIRFAX ST STE 204A
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2633
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Country | US
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Telephone | 202-596-1031
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Fax |
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Provider Business Mailing Address
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Address Line | 301 N FAIRFAX ST STE 204A
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2633
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Country | US
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Telephone | 202-596-1031
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL PSYCHOLOGIST
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Name | DR. MARCUS R PATTERSON
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Credential | PSYD
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Telephone | 202-596-1031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0810005630
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License Number State | VA
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