Provider Demographics
NPI:1235748294
Name:COMPASSIONATE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:COMPASSIONATE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELYSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SELZER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, LSCSW, LCAC
Authorized Official - Phone:620-315-4073
Mailing Address - Street 1:1807 E MARY ST STE 5
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-3877
Mailing Address - Country:US
Mailing Address - Phone:620-315-4073
Mailing Address - Fax:620-315-4320
Practice Address - Street 1:1807 E MARY ST STE 6
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-3877
Practice Address - Country:US
Practice Address - Phone:785-477-0188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201313910AMedicaid