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General NPI Number Information
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NPI Number | 1700547874
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Entity Type | Organization
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Legal Business Name | GOLD COMPASS COUNSELING, LLC
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Dates
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Enumeration Date | 12/31/2021
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Last Update Date | 12/31/2021
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Provider Practice Location Address
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Address Line | 23104 N 67TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85310-5727
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Country | US
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Telephone | 520-365-3801
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Fax |
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Provider Business Mailing Address
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Address Line | 6635 W HAPPY VALLEY RD STE A104-165
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City | GLENDALE
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State | AZ
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Zip | 85310-2609
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Country | US
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Telephone | 520-365-3801
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Fax |
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Authorized Official
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Title or Position | OWNER, COUNSELOR
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Name | MRS. SAMANTHA GRAHAM
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Credential | LPC
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Telephone | 520-365-3801
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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 |
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License Number State |
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