Organization
FULL CIRCLE WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONIA JACOBS DEESE MSW, LCSW (OWNER, DIRECTOR)
(919) 619-7379
Entity
Organization
Contact information
Practice address
6416 CARMEL RD STE 408, CHARLOTTE, NC 28226-8268
(980) 428-9174
Mailing address
3908 ASHTON DR, CHARLOTTE, NC 28210-6844
(919) 619-7379
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053153254
NPI
NC
Enumeration date
05/20/2024
Last updated
02/06/2025
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