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General NPI Number Information
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NPI Number | 1730795337
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Entity Type | Organization
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Legal Business Name | FULL CIRCLE PSYCHOTHERAPY
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 6741 SEBASTOPOL AVE STE 110
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City | SEBASTOPOL
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State | CA
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Zip | 95472-3838
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Country | US
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Telephone | 510-326-3959
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Fax |
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Provider Business Mailing Address
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Address Line | 6741 SEBASTOPOL AVE STE 110
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City | SEBASTOPOL
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State | CA
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Zip | 95472-3838
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Country | US
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Telephone | 510-326-3959
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. CORINNE BARROWS
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Credential | LCSW 96438
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Telephone | 510-326-3959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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