Provider Demographics
NPI:1518173731
Name:COMPASS RESOURCES, LLC
Entity Type:Organization
Organization Name:COMPASS RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-323-0734
Mailing Address - Street 1:2829 DALLAS STREET
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144
Mailing Address - Country:US
Mailing Address - Phone:404-323-0734
Mailing Address - Fax:
Practice Address - Street 1:2829 DALLAS STREET
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144
Practice Address - Country:US
Practice Address - Phone:404-323-0734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004388101Y00000X
GALPC004712101Y00000X
GALPC004747101Y00000X
GAPSY002025103T00000X
GAPSY002456103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty