Provider Demographics
NPI:1376064717
Name:COMPASS PROFESSIONAL COUNSELORS LLC
Entity Type:Organization
Organization Name:COMPASS PROFESSIONAL COUNSELORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LOSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LLC
Authorized Official - Phone:570-359-7303
Mailing Address - Street 1:359 S MOUNTAIN BLVD STE B2
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-1984
Mailing Address - Country:US
Mailing Address - Phone:570-359-7303
Mailing Address - Fax:570-474-5278
Practice Address - Street 1:359 S MOUNTAIN BLVD STE B2
Practice Address - Street 2:
Practice Address - City:MOUNTAIN TOP
Practice Address - State:PA
Practice Address - Zip Code:18707-1984
Practice Address - Country:US
Practice Address - Phone:570-359-7303
Practice Address - Fax:570-474-5278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006039101YM0800X
PAPC007925101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty