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General NPI Number Information
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NPI Number | 1114465036
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE PATHWAYS COUNSELING LLC
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Dates
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Enumeration Date | 02/11/2017
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Last Update Date | 02/11/2017
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Provider Practice Location Address
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Address Line | 17505 N 79TH AVE STE 213
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City | GLENDALE
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State | AZ
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Zip | 85308-8728
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Country | US
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Telephone | 623-377-0373
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Fax |
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Provider Business Mailing Address
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Address Line | 18263 W BANFF LN
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City | SURPRISE
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State | AZ
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Zip | 85388-7662
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Country | US
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Telephone | 623-377-0373
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MANDY SCHULZKE
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Credential |
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Telephone | 623-377-0373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 16536
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License Number State | AZ
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