Provider Demographics
NPI:1275899858
Name:COMPASSIONATE THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:COMPASSIONATE THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:520-395-0179
Mailing Address - Street 1:3571 S DOUBLE ECHO RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85735-5130
Mailing Address - Country:US
Mailing Address - Phone:520-395-0179
Mailing Address - Fax:520-395-0179
Practice Address - Street 1:3057 S KINNEY RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-5537
Practice Address - Country:US
Practice Address - Phone:520-395-0179
Practice Address - Fax:520-300-8342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-08
Last Update Date:2013-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-133791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLCSW13379OtherLCSW LICENSE