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NPI Code Detail

MEDICARE: FULL CIRCLE WELLNESS AND PSYCHOTHERAPY, PLLC

MEDICARE: FULL CIRCLE WELLNESS AND PSYCHOTHERAPY, PLLC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1538806872
Entity Type Code : Organization
Provider Name (Legal Business Name) : FULL CIRCLE WELLNESS AND PSYCHOTHERAPY, PLLC
Provider Business Mailing Address
First Line : 102 W 3RD ST STE 1000
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27101-3996
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 601 QUAIL VALLEY DR # 327
Second Line :
City : GEORGETOWN
State : TX
Zip : 78626-8051
Country : US
Telephone Number : 541-727-8542
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. KERRIE ROUSE
Credential : PHD, LPC, LMFT
Telephone Number : 541-727-8542
Provider Enumeration Date : 05/18/2022
Last Update Date : 02/12/2026

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Directions to “FULL CIRCLE WELLNESS AND PSYCHOTHERAPY, PLLC ” Practice Location

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