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General NPI Number Information
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NPI Number | 1679216972
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Entity Type | Organization
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Legal Business Name | COMPASS INTEGRATIVE COUNSELING LLC
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 5507 RANCH DR STE 202
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City | LITTLE ROCK
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State | AR
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Zip | 72223-0043
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Country | US
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Telephone | 501-291-3732
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Fax | 501-251-1091
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Provider Business Mailing Address
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Address Line | 5507 RANCH DR STE 202
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City | LITTLE ROCK
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State | AR
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Zip | 72223-0043
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Country | US
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Telephone | 501-291-3732
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Fax | 501-251-1091
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | MARTIN C SKRIVANOS
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Credential | LPC
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Telephone | 501-291-3732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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