MEDICARE: FULL SPHERE COUNSELING AND CONSULTING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

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

Provider Business Mailing Address
First Line	:	8326 HAMBLETONIAN DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45249-1308
Country	:	US
Telephone Number	:	513-223-0767
Fax Number	:

Provider Business Practice Location Address
First Line	:	1658 HERALD AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45207
Country	:	US
Telephone Number	:	513-223-0767
Fax Number	:

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

Provider Enumeration Date	:	01/01/2024
Last Update Date	:	01/01/2024

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Directions to “FULL SPHERE COUNSELING AND CONSULTING SERVICES, LLC ” Practice Location

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