Organization Active NPI

Full Circle Counseling, LLC

  • Social Worker
  • Lincoln Park, NJ
National Provider Identifier
1174788715
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SC04697500 Issued in NJ
Legal business name
FULL CIRCLE COUNSELING, LLC
Practice address
63 Beaverbrook Rd
Suite 206
Lincoln Park, NJ 07035-1440
Phone
(973) 694-1950
Fax
(973) 694-1952
NPI assigned
Jul 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jordan Brown, MSW, LSW
Title
Owner/Therapist/Provider
Phone
(201) 370-6906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 44SC04697500 NJ Primary

Addresses

Primary practice location

63 Beaverbrook Rd
Suite 206
Lincoln Park, NJ 07035-1440

Mailing address

63 Beaverbrook Rd
Suite 206
Lincoln Park, NJ 07035-1440
Phone (973) 694-1950

Other identifiers 1

IdentifierTypeStateIssuer
0161454MedicaidNJ

National Provider Directory

National Provider Directory

Locations

63 Beaverbrook Rd
Ste 206
Lincoln Park, NJ 07035
Phone (201) 247-3925

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1174788715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 BEAVERBROOK RD",
            "address_2": "SUITE 206",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070351440",
            "telephone_number": "973-694-1950",
            "fax_number": "973-694-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 BEAVERBROOK RD",
            "address_2": "SUITE 206",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070351440",
            "telephone_number": "973-694-1950",
            "fax_number": "973-694-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CIRCLE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "OWNER/THERAPIST/PROVIDER",
        "authorized_official_telephone_number": "201-370-6906",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, LSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SC04697500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0161454",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.