# FULL CIRCLE THERAPY CENTER, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Full Circle Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578011458
- **Authorized official:** NICOLE SIEGEL LCSW, LCDC (OWNER, THERAPIST)
- **Authorized official phone:** (972) 754-6681

## Contact information

- **Practice address:** 2485 E SOUTHLAKE BLVD STE 180, SOUTHLAKE, TX 76092-6687
- **Practice address phone:** (682) 593-1272
- **Mailing address:** 4142 PETERSBURG DR, FORT WORTH, TX 76244-4373
- **Mailing address phone:** (972) 754-6681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 57444 | TX | Yes |

## Other

- **Enumeration date:** 09/20/2016
- **Last updated:** 09/20/2016