Full Health Journey, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

FULL HEALTH JOURNEY, LLC

Doing business as

Full Health Journey, LLC

Practice address

12785 Pinnacle LN
Venice, FL 34293-5161

Phone

(630) 487-0795

NPI assigned

May 1, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Dawn Catherine Kroencke, PH.D.NPI 1497731962

Title

Clinical Psychologist/Owner

Phone

(630) 487-0795

Specialties & licenses 1

Addresses

Other names 1

• Full Health Journey, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

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.

• Dawn Catherine Kroencke, PHD LP

  • Clinical Psychologist
  • Venice, FL
  • NPI 1497731962

  IL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1659128387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2357 S TAMIAMI TRAIL STE 3",
            "address_2": "PMB 174",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935161",
            "telephone_number": "941-218-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12785 PINNACLE LN",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935161",
            "telephone_number": "630-487-0795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1208 Iroquois Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "60563",
            "country_code": "US",
            "telephone_number": "941-218-3821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FULL HEALTH JOURNEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "KROENCKE",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "630-487-0795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Full Health Journey, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Full Health Journey, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Psychologist in Venice, FL
• Providers in Venice, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.