Healthcare Provider Details

I. General information

NPI: 1083529622
Provider Name (Legal Business Name): MICHELLE POMPOS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 SILVER CREEK RD STE 205
BULLHEAD CITY AZ
86442-8347
US

IV. Provider business mailing address

2915 FORT SILVER DR
BULLHEAD CITY AZ
86429-1123
US

V. Phone/Fax

Practice location:
  • Phone: 928-393-0139
  • Fax:
Mailing address:
  • Phone: 989-980-5118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLMSW-21641
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: