Provider Demographics
NPI:1275074692
Name:COMPASSIONATE PSYCHIATRIC SERVICES LLC
Entity Type:Organization
Organization Name:COMPASSIONATE PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:772-332-2635
Mailing Address - Street 1:2941 BENT PINE DR
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34951-2923
Mailing Address - Country:US
Mailing Address - Phone:772-332-2635
Mailing Address - Fax:
Practice Address - Street 1:1702 CLUB DR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-2258
Practice Address - Country:US
Practice Address - Phone:772-332-2635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-18
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2827802363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty