Provider Demographics
NPI: | 1285290403 |
---|---|
Name: | COMPASS LIFE SKILLS AND COUNSELING, PLLC |
Entity type: | Organization |
Organization Name: | COMPASS LIFE SKILLS AND COUNSELING, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER, THERAPIST |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | CRYSTAL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CURRIE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPCA, NCC, BC-TMH |
Authorized Official - Phone: | 704-336-0366 |
Mailing Address - Street 1: | 3515 DAVID COX RD UNIT 481321 |
Mailing Address - Street 2: | |
Mailing Address - City: | CHARLOTTE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28269-2537 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 704-336-0366 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8824 CLIFF CAMERON DR APT 107 |
Practice Address - Street 2: | |
Practice Address - City: | CHARLOTTE |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28269-0839 |
Practice Address - Country: | US |
Practice Address - Phone: | 704-336-0366 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-05-13 |
Last Update Date: | 2019-05-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |