Healthcare Provider Details

I. General information

NPI: 1275111411
Provider Name (Legal Business Name): COMPASSION THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4043 VIOLET AVE
SAINT CLAIR MI
48079-3532
US

IV. Provider business mailing address

4043 VIOLET AVE
SAINT CLAIR MI
48079-3532
US

V. Phone/Fax

Practice location:
  • Phone: 810-300-6614
  • Fax:
Mailing address:
  • Phone: 810-300-6614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: YUVONNE MARIE WROBEL
Title or Position: CO OWNER
Credential: LPC
Phone: 810-300-6614