1063724953 NPI number — COMPASSIONATE COUNSELING

Table of content: (NPI 1063724953)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063724953 NPI number — COMPASSIONATE COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPASSIONATE COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063724953
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 93
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNDERWOOD
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98651-0093
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-980-1919
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 W STEUBEN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BINGEN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-493-1143
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2010

Additional Information

Authorized Official

Authorized Official Last Name:
OAKS
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
DAVIS
Authorized Official Title or Position:
LICENSED MENTAL HEALTH COUNSELOR
Authorized Official Telephone Number:
509-493-1143

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LH60051192 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: LH60118130 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com