Provider Demographics
NPI:1457087629
Name:COMPASSIONATE LIFE COUNSELING PLLC
Entity Type:Organization
Organization Name:COMPASSIONATE LIFE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ROKOSZ
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:704-345-7404
Mailing Address - Street 1:3013 STRAWBERRY RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-6206
Mailing Address - Country:US
Mailing Address - Phone:704-345-7404
Mailing Address - Fax:
Practice Address - Street 1:7733 BALLANTYNE COMMONS PKWY # 201-F
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4396
Practice Address - Country:US
Practice Address - Phone:704-228-3813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty