Provider Demographics
NPI:1679216972
Name:COMPASS INTEGRATIVE COUNSELING LLC
Entity Type:Organization
Organization Name:COMPASS INTEGRATIVE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SKRIVANOS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:501-291-3732
Mailing Address - Street 1:5507 RANCH DR STE 202
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-0043
Mailing Address - Country:US
Mailing Address - Phone:501-291-3732
Mailing Address - Fax:501-251-1091
Practice Address - Street 1:5507 RANCH DR STE 202
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-0043
Practice Address - Country:US
Practice Address - Phone:501-291-3732
Practice Address - Fax:501-251-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1386193209OtherLPC