MEDICARE: COMPASS MENTAL HEALTH & WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YP2500X	Professional Counselor
3	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1184567646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASS MENTAL HEALTH & WELLNESS LLC

Provider Business Mailing Address
First Line	:	650 N PENROD RD STE A
Second Line	:
City	:	SHOW LOW
State	:	AZ
Zip	:	85901-5284
Country	:	US
Telephone Number	:	520-481-7461
Fax Number	:

Provider Business Practice Location Address
First Line	:	4672 MAVERICK LN STE 1A
Second Line	:
City	:	LAKESIDE
State	:	AZ
Zip	:	85929-5434
Country	:	US
Telephone Number	:	520-481-7461
Fax Number	:

Authorized Official
Title or Position	:	OWNER, CEO
Name	:	MR. NICOLAE CODRUT MARIN
Credential	:	LAC
Telephone Number	:	520-481-7461

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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