Provider Demographics
NPI:1386282416
Name:LIFE COMPASS THERAPY, LLC
Entity type:Organization
Organization Name:LIFE COMPASS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT,
Authorized Official - Phone:757-943-9555
Mailing Address - Street 1:5226 INDIAN RIVER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BCH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-6179
Mailing Address - Country:US
Mailing Address - Phone:757-943-9555
Mailing Address - Fax:757-664-9494
Practice Address - Street 1:5226 INDIAN RIVER RD STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BCH
Practice Address - State:VA
Practice Address - Zip Code:23464-6179
Practice Address - Country:US
Practice Address - Phone:757-943-9555
Practice Address - Fax:757-664-9494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-19
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty