Provider Demographics
NPI:1114465036
Name:COMPASSIONATE PATHWAYS COUNSELING LLC
Entity Type:Organization
Organization Name:COMPASSIONATE PATHWAYS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULZKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-377-0373
Mailing Address - Street 1:18263 W BANFF LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-7662
Mailing Address - Country:US
Mailing Address - Phone:623-377-0373
Mailing Address - Fax:
Practice Address - Street 1:17505 N 79TH AVE STE 213
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8728
Practice Address - Country:US
Practice Address - Phone:623-377-0373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-11
Last Update Date:2017-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16536101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty