Full Circle Family Services at White Brook Farm, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

009611 Issued in CT

Legal business name

FULL CIRCLE FAMILY SERVICES AT WHITE BROOK FARM, LLC

Practice address

181 Main St
Danielson, CT 06239-2815

Phone

(860) 753-6015

Fax

(877) 552-0608

NPI assigned

Feb 16, 2017

Organization subpart

No

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

Authorized official

Name

Lisa Marie Rivera, LCSWNPI 1053856989

Title

Owner

Phone

(860) 753-6015

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

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

• Lisa Marie Rivera, LCSW

  • Clinical Social Worker
  • Danielson, CT
  • NPI 1053856989
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1326587882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062390067",
            "telephone_number": "860-753-6015",
            "fax_number": "877-552-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 MAIN ST",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062392815",
            "telephone_number": "860-753-6015",
            "fax_number": "877-552-0608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147B Route 169",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "CT",
            "postal_code": "062813327",
            "country_code": "US",
            "telephone_number": "860-753-6015",
            "fax_number": "877-552-0608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Frog Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "CT",
            "postal_code": "062813009",
            "country_code": "US",
            "telephone_number": "860-753-6015",
            "fax_number": "877-552-0608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FULL CIRCLE FAMILY SERVICES AT WHITE BROOK FARM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-16",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "LISA MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-753-6015",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward G Duval, D.M.D.
• Lacey Elton, LCSW
• Stephanie Erica Farmer, PA-C
• Daniel E Fiore, R.PH.
• Freedom Lifts LLC
• Amy L Gagne, LADC
• Daniel Gallant
• Ellenore G Garvie
• Generations Family Health Center Inc
• Matthew R Gilbert, CPHT

• Clinical Social Worker in Danielson, CT
• Providers in Danielson, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.