Provider Demographics
NPI:1346724747
Name:COMPASS COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:COMPASS COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEC
Authorized Official - Middle Name:STORM
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, LCSW
Authorized Official - Phone:903-715-2004
Mailing Address - Street 1:PO BOX 776
Mailing Address - Street 2:
Mailing Address - City:FORT GIBSON
Mailing Address - State:OK
Mailing Address - Zip Code:74434-0776
Mailing Address - Country:US
Mailing Address - Phone:903-715-2004
Mailing Address - Fax:918-203-3116
Practice Address - Street 1:908 S LEE ST STE A
Practice Address - Street 2:
Practice Address - City:FORT GIBSON
Practice Address - State:OK
Practice Address - Zip Code:74434-8735
Practice Address - Country:US
Practice Address - Phone:903-715-2004
Practice Address - Fax:918-203-3116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty