Provider Demographics
NPI:1508303447
Name:COMPASS COUNSELING SERVICES
Entity Type:Organization
Organization Name:COMPASS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HEITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CADC II, LPC-INTERN
Authorized Official - Phone:541-819-9789
Mailing Address - Street 1:530 NW 3RD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-3646
Mailing Address - Country:US
Mailing Address - Phone:541-819-9789
Mailing Address - Fax:541-272-5288
Practice Address - Street 1:530 NW 3RD ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-3646
Practice Address - Country:US
Practice Address - Phone:541-819-9789
Practice Address - Fax:541-272-5288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR-3823101Y00000X, 101YM0800X
OR11-R-22101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty