Organization Active NPI

Full Circle Therapy LLC

  • Clinical Social Worker
  • Champaign, IL
National Provider Identifier
1689541195
Registry record updated Nov 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FULL CIRCLE THERAPY LLC
Practice address
2919 Crossing CT Ste 8
Champaign, IL 61822-5904
Phone
(217) 275-8811
Fax
(217) 600-3205
NPI assigned
Oct 20, 2025
Last updated
Nov 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2025

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

Authorized official

Name
Kathleen El Koury, LCSWNPI 1386923340
Title
Owner
Phone
(217) 275-8811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2919 Crossing CT Ste 8
Champaign, IL 61822-5904

Mailing address

2919 Crossing CT Ste 8
Champaign, IL 61822-5904
Phone (217) 275-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251117002006 IL Part B Supplier - Clinic/Group Practice 5799276853 Receives reassigned benefits from 1 practitioner
Practice locations: Champaign, IL

National Provider Directory

National Provider Directory

Locations

2919 Crossing Ct
Ste 8
Champaign, IL 61822
Phone (217) 275-8811

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761955200000",
    "number": "1689541195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 CROSSING CT STE 8",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618225904",
            "telephone_number": "217-275-8811",
            "fax_number": "217-600-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 CROSSING CT STE 8",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618225904",
            "telephone_number": "217-275-8811",
            "fax_number": "217-600-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CIRCLE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-11-01",
        "certification_date": "2025-11-01",
        "status": "A",
        "authorized_official_last_name": "EL KOURY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-275-8811",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

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