Provider Demographics
NPI:1366831521
Name:COMPASSION COUNSELING LLC
Entity Type:Organization
Organization Name:COMPASSION COUNSELING LLC
Other - Org Name:NOW FAITH THAT WORKS CHRISTIAN CHURCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LCSW/CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:FELICIA
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-721-6750
Mailing Address - Street 1:5923 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803
Mailing Address - Country:US
Mailing Address - Phone:804-957-6389
Mailing Address - Fax:
Practice Address - Street 1:5923 CHURCH RD
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803
Practice Address - Country:US
Practice Address - Phone:804-721-6750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904003479251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4945280Medicaid