Provider Demographics
NPI:1679065262
Name:COMPASS COUNSELING GROUP
Entity Type:Organization
Organization Name:COMPASS COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FACEMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW-S
Authorized Official - Phone:310-729-9978
Mailing Address - Street 1:PO BOX 1383
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:43008-1383
Mailing Address - Country:US
Mailing Address - Phone:740-527-0396
Mailing Address - Fax:
Practice Address - Street 1:5312 WALNUT RD
Practice Address - Street 2:
Practice Address - City:BUCKEYE LAKE
Practice Address - State:OH
Practice Address - Zip Code:43008
Practice Address - Country:US
Practice Address - Phone:740-527-0396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1600651-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty