Provider Demographics
NPI:1326756693
Name:COMPASS ORANGE BULLYING PREVENTION & COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:COMPASS ORANGE BULLYING PREVENTION & COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CAROLINE
Authorized Official - Last Name:ALBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:ED D, LPC
Authorized Official - Phone:678-670-9055
Mailing Address - Street 1:158 DENE DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-6349
Mailing Address - Country:US
Mailing Address - Phone:678-670-9055
Mailing Address - Fax:
Practice Address - Street 1:158 DENE DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-6349
Practice Address - Country:US
Practice Address - Phone:678-670-9055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health