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Organization
FULL CIRCLE WELLNESS CENTER, INC.
Active
Organization
FULL CIRCLE WELLNESS CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA ANNE GRAY LCSW (EXECUTIVE DIRECTOR)
(207) 942-5055
Entity
Organization
Contact information
Practice address
265 HAMMOND ST, BANGOR, ME 04401-4610
(207) 942-5055
(207) 942-7013
Mailing address
PO BOX 1237, BANGOR, ME 04402-1237
(207) 942-5055
(207) 942-7013
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
103TF0200X
Forensic Psychologist
—
NULL
103TF0200X
Forensic Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
08/30/2006
Last updated
09/19/2013
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