Full Potential LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FULL POTENTIAL LLC

Practice address

308 Hay St Ste D
Fayetteville, NC 28301-5574

Phone

(910) 860-3855

NPI assigned

Jun 25, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Jerome Johnson, MSW, PLCSW

Title

Director

Phone

(910) 860-3855

Specialties & licenses 1

Addresses

Tax ID family

Full Potential at Pembroke3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Full Potential, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Lumberton, NC
  • NPI 1083747828
  NPD tax ID
• Full Potential,LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Fayetteville, NC
  • NPI 1639219348
  NPD tax ID

Locations

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1922236140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25681",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283145011",
            "telephone_number": "910-860-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 HAY ST STE D",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015574",
            "telephone_number": "910-860-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL POTENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-860-3855",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, PLCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Fuentes
• Katherine Andrade Fuentes
• Belinda Kaydianne Fugalli, PA-C
• Megan Fulden
• Full Circle Therapeutic Services, PLLC
• Full Potential,LLC
• Angel Marie Fuller, LCSW-A
• Daphne Fuller, LPC
• Eliza A Fuller
• Lisa Lynn Fuller, MPT

• Community/Behavioral Health Agency in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.