Provider Demographics
NPI:1013544808
Name:COMPASS MENTAL HEALTH COUNSELING PLLC
Entity Type:Organization
Organization Name:COMPASS MENTAL HEALTH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:716-524-1311
Mailing Address - Street 1:PO BOX 1633
Mailing Address - Street 2:
Mailing Address - City:NIAGARA UNIVERSITY
Mailing Address - State:NY
Mailing Address - Zip Code:14109-1633
Mailing Address - Country:US
Mailing Address - Phone:716-341-9258
Mailing Address - Fax:
Practice Address - Street 1:3117 MILITARY RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-4813
Practice Address - Country:US
Practice Address - Phone:716-341-9258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOM MEDICAL PRACTICE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty