Provider Demographics
NPI:1356669360
Name:COMPASS COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:COMPASS COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-635-4141
Mailing Address - Street 1:4000 S 700 E
Mailing Address - Street 2:STE 9
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2180
Mailing Address - Country:US
Mailing Address - Phone:801-635-4141
Mailing Address - Fax:801-263-4333
Practice Address - Street 1:3970 S 700 E
Practice Address - Street 2:OLD FARM PROFESSIONAL PLAZA #17
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2191
Practice Address - Country:US
Practice Address - Phone:801-635-4141
Practice Address - Fax:801-263-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT295041-2501251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health