Provider Demographics
NPI:1255833901
Name:COMPASS COUNSELING AND CONSULTING WITH J. CARROLL LTD.
Entity Type:Organization
Organization Name:COMPASS COUNSELING AND CONSULTING WITH J. CARROLL LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:MED LCPC
Authorized Official - Phone:618-363-5411
Mailing Address - Street 1:1114 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-2219
Mailing Address - Country:US
Mailing Address - Phone:618-363-5411
Mailing Address - Fax:618-551-7084
Practice Address - Street 1:200 W 3RD ST STE 509
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6174
Practice Address - Country:US
Practice Address - Phone:618-972-5870
Practice Address - Fax:618-551-7084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007989251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health