Provider Demographics
NPI:1114793080
Name:COMPASSIONATE CONNECTIONS COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:COMPASSIONATE CONNECTIONS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MH
Authorized Official - Phone:605-215-5713
Mailing Address - Street 1:3508 S MINNESOTA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6457
Mailing Address - Country:US
Mailing Address - Phone:605-215-5713
Mailing Address - Fax:605-674-7536
Practice Address - Street 1:3508 S MINNESOTA AVE STE 100
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6457
Practice Address - Country:US
Practice Address - Phone:605-215-5713
Practice Address - Fax:605-674-7536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)