Organization
FULL CIRCLE THERAPIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE PATRICIA DAVIS LCSW (DIRECTOR)
(732) 861-8765
Entity
Organization
Contact information
Practice address
119 VIVAS DR, BARNEGAT, NJ 08005-2593
(732) 867-8765
Mailing address
119 VIVAS DR, BARNEGAT, NJ 08005-2593
(732) 867-8765
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SC05188000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
394664
MEDICARE PTAN
NJ
Enumeration date
09/14/2016
Last updated
09/14/2016
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