Provider Demographics
NPI:1548778095
Name:COMPASSIONATE CARE COUNSELING SERVICES
Entity Type:Organization
Organization Name:COMPASSIONATE CARE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELANA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:KLEMM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:404-783-7086
Mailing Address - Street 1:4343 SHALLOWFORD RD STE H1B
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5025
Mailing Address - Country:US
Mailing Address - Phone:404-783-7086
Mailing Address - Fax:404-783-7086
Practice Address - Street 1:4343 SHALLOWFORD RD STE H1B
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5025
Practice Address - Country:US
Practice Address - Phone:404-783-7086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC0001794101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty