Full Moon Wellness and Consulting, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

FULL MOON WELLNESS AND CONSULTING, LLC

Practice address

7155 SW Varns St Ste 215
Portland, OR 97223-8175

Phone

(503) 894-7144

NPI assigned

Oct 30, 2024

Organization subpart

No

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

Authorized official

Name

Stephanie Higgason, LCSWNPI 1063699627

Title

Owner/LCSW

Phone

(720) 250-7911

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 2

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

• Stephanie Ann Higgason, LCSW

  • Clinical Social Worker
  • Portland, OR
  • NPI 1063699627
  Medicare reassignment NPD Authorized official
• Kennedy Olivia Fowle, LCSW

  • Clinical Social Worker
  • Seattle, WA
  • NPI 1205537594

  OR

  Medicare reassignment NPD

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1952123861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7155 SW VARNS ST STE 215",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7155 SW VARNS ST STE 215",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238175",
            "telephone_number": "503-894-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL MOON WELLNESS AND CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-30",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "HIGGASON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER/LCSW",
        "authorized_official_telephone_number": "720-250-7911",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Anne-Marie Fulcher
• Davia Fulford
• Deborah K Fulkerson, OT
• Full Circle Community Services
• Full Circle Ecotherapy and Family Services LLC
• Full Spectrum Therapy LLC
• Bret Eugene Fuller, PH.D.
• Chelsey Marie Fuller
• Jesse Fuller
• Joleen Fuller, LAC

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

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