Fullcircle Counseling Service and Consultation

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4911 Issued in SC

Legal business name

FULLCIRCLE COUNSELING SERVICE AND CONSULTATION

Practice address

105 Paces Brook Ave
#518
Columbia, SC 29212-1642

Phone

(803) 467-4125

Fax

(803) 569-6523

NPI assigned

Mar 25, 2015

Last updated

Mar 25, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Leon Martin, LPCNPI 1093899007

Title

Owner

Phone

(803) 467-4125

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Leon Martin, MA, LPC

  • Mental Health Counselor
  • Columbia, SC
  • NPI 1093899007
  Authorized official Same address or phone

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1417341611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PACES BROOK AVE",
            "address_2": "#518",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121642",
            "telephone_number": "803-467-4125",
            "fax_number": "803-569-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PACES BROOK AVE",
            "address_2": "#518",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121642",
            "telephone_number": "803-467-4125",
            "fax_number": "803-569-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLCIRCLE COUNSELING SERVICE AND CONSULTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-467-4125",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "4911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1102",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronnie S Fuerst, MD
• Lora Lee Fuhrmann, ATC
• Gregory K Fulcher, MD
• Susan Schnell Fulkerson, PHARM.D.
• Rebecca Fullam, NP
• Amyeishia Fuller
• Anna Catherine Fuller
• Anna Tyson Fuller, D.M.D.
• Isaac Fuller
• Jasmine Fuller, RBT

• Professional Counselor in Columbia, SC
• Providers in Columbia, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.