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General NPI Number Information
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NPI Number | 1255833901
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Entity Type | Organization
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Legal Business Name | COMPASS COUNSELING AND CONSULTING WITH J. CARROLL LTD.
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 200 W 3RD ST STE 509
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City | ALTON
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State | IL
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Zip | 62002-6174
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Country | US
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Telephone | 618-972-5870
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Fax | 618-551-7084
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Provider Business Mailing Address
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Address Line | 1114 DOUGLAS ST
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City | ALTON
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State | IL
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Zip | 62002-2219
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Country | US
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Telephone | 618-363-5411
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Fax | 618-551-7084
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Authorized Official
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Title or Position | PRESIDENT
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Name | JULIA L. CARROLL
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Credential | M.ED. LCPC
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Telephone | 618-363-5411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 180.007989
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License Number State | IL
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