Full Circle Behavioral LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FULL CIRCLE BEHAVIORAL LLC

Practice address

2249 Goodyear Blvd
Danville, VA 24541-6613

Phone

(336) 524-3730

NPI assigned

May 21, 2021

Organization subpart

No

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

Authorized official

Name

Fedena Jean

Title

Ceo

Phone

(336) 524-3730

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fedena C Wade, LCSW

  • Clinical Social Worker
  • Danville, VA
  • NPI 1114776309
  NPD

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1831764034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 CHESTNUT PL",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411812",
            "telephone_number": "336-524-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2249 GOODYEAR BLVD",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245416613",
            "telephone_number": "336-524-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CIRCLE BEHAVIORAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A",
        "authorized_official_last_name": "JEAN",
        "authorized_official_first_name": "FEDENA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-524-3730"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kelly R Fuller, FNP-C
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• Community/Behavioral Health Agency in Danville, VA
• Providers in Danville, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.