Organization Active NPI

Full Circle Psychotherapy

  • Mental Health Counselor
  • Sebastopol, CA
National Provider Identifier
1730795337
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FULL CIRCLE PSYCHOTHERAPY
Practice address
6741 Sebastopol Ave Ste 110
Sebastopol, CA 95472-3838
Phone
(510) 326-3959
NPI assigned
Sep 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Authorized official

Name
Mrs. Corinne Barrows, LCSW 96438NPI 1619483260
Title
Therapist
Phone
(510) 326-3959

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

6741 Sebastopol Ave Ste 110
Sebastopol, CA 95472-3838

Mailing address

6741 Sebastopol Ave Ste 110
Sebastopol, CA 95472-3838
Phone (510) 326-3959

Other identifiers 2

IdentifierTypeStateIssuer
1093323669MedicaidCA
1619483260MedicaidCA

National Provider Directory

National Provider Directory

Locations

6741 Sebastopol Ave
Ste 110
Sebastopol, CA 95472
Phone (510) 326-3959

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": "1600387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600387200000",
    "number": "1730795337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6741 SEBASTOPOL AVE STE 110",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723838",
            "telephone_number": "510-326-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6741 SEBASTOPOL AVE STE 110",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723838",
            "telephone_number": "510-326-3959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CIRCLE PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A",
        "authorized_official_last_name": "BARROWS",
        "authorized_official_first_name": "CORINNE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "510-326-3959",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW 96438"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093323669",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619483260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.