Provider Demographics
NPI:1548994270
Name:COMPASSIONATE HEART CHRISTIAN COUNSELING, PLLC
Entity type:Organization
Organization Name:COMPASSIONATE HEART CHRISTIAN COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BONILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LAC
Authorized Official - Phone:480-420-7514
Mailing Address - Street 1:651 N VAL VISTA RD
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85119-8643
Mailing Address - Country:US
Mailing Address - Phone:148-081-8709
Mailing Address - Fax:
Practice Address - Street 1:3200 N DOBSON RD STE D-3
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-9610
Practice Address - Country:US
Practice Address - Phone:480-420-7514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-09
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty