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General NPI Number Information
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NPI Number | 1205572559
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Entity Type | Organization
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Legal Business Name | COMPASS THERAPEUTIC ALLIANCE, A LICENSED CLINICAL SOCIAL WORKER CO
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 14500 ROSCOE BLVD STE 400
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4194
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Country | US
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Telephone | 818-800-2738
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Fax |
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Provider Business Mailing Address
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Address Line | 14500 ROSCOE BLVD STE 400
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4194
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Country | US
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Telephone | 818-800-2738
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | TODD WALKER
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Credential | LCSW
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Telephone | 818-800-2738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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