NPIMap

Organization Active NPI

Full Circle Counseling and Recovery, LLC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Eastsound, WA
National Provider Identifier
1770866857
Registry record updated Sep 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
AP30006672 Issued in WA
Legal business name
FULL CIRCLE COUNSELING AND RECOVERY, LLC
Practice address
1286 Mount Baker Rd Ste B208
Eastsound, WA 98245-8931
Phone
(360) 376-6181
Fax
(360) 376-6182
NPI assigned
Sep 24, 2011
Last updated
Sep 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2011

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

Authorized official

Name
Anne M. Gresham, CNS, ARNPNPI 1164441648
Title
Registered Agent
Phone
(360) 376-6181

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
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60026508 WA
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X AP30006672 WA Primary

Addresses

Primary practice location

1286 Mount Baker Rd Ste B208
Eastsound, WA 98245-8931

Mailing address

PO Box 363
Eastsound, WA 98245-0363
Phone (360) 376-6181

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1316822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316822400000",
    "number": "1770866857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 363",
            "city": "EASTSOUND",
            "state": "WA",
            "postal_code": "982450363",
            "telephone_number": "360-376-6181",
            "fax_number": "360-376-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1286 MOUNT BAKER RD STE B208",
            "city": "EASTSOUND",
            "state": "WA",
            "postal_code": "982458931",
            "telephone_number": "360-376-6181",
            "fax_number": "360-376-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CIRCLE COUNSELING AND RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-24",
        "last_updated": "2011-09-24",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "360-376-6181",
        "authorized_official_credential": "CNS, ARNP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60026508",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "AP30006672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastsound, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2011; 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.