Provider Demographics
NPI:1174861314
Name:COMPASSION PROJECT
Entity Type:Organization
Organization Name:COMPASSION PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:STINE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-254-1397
Mailing Address - Street 1:1011 E HIGHWAY 218
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-7020
Mailing Address - Country:US
Mailing Address - Phone:704-254-1397
Mailing Address - Fax:
Practice Address - Street 1:1011 E HIGHWAY 218
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7020
Practice Address - Country:US
Practice Address - Phone:704-254-1397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0042711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty