=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679438683
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FULL CIRCLE BEHAVIORAL HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2025
-----------------------------------------------------
Last Update Date | 12/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16 RICCI DR
-----------------------------------------------------
City | NORTH PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02911-2418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-767-7156
-----------------------------------------------------
Fax | 401-205-8807
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16 RICCI DR
-----------------------------------------------------
City | NORTH PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02911-2418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax | 401-205-8807
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL/FOUNDER
-----------------------------------------------------
Name | ESTRELLITA MORONTA
-----------------------------------------------------
Credential | DSW, LICSW
-----------------------------------------------------
Telephone | 401-767-7156
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------