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General NPI Number Information
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NPI Number | 1942848254
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Entity Type | Organization
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Legal Business Name | FULL CIRCLE PSYCHOLOGY, LLC
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Dates
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Enumeration Date | 12/17/2019
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 324 E MAIN ST
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City | NORTHVILLE
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State | MI
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Zip | 48167-7400
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Country | US
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Telephone | 734-812-4577
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Fax |
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Provider Business Mailing Address
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Address Line | 21740 MERIDIAN LN
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City | NOVI
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State | MI
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Zip | 48375-4941
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Country | US
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Telephone | 734-812-4577
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SABRINA MITCHELL
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Credential | LMSW, CAADC
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Telephone | 734-812-4577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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