Provider Demographics
NPI:1790157626
Name:COMPASS COUNSELING SERVICES,LLC
Entity Type:Organization
Organization Name:COMPASS COUNSELING SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-823-8421
Mailing Address - Street 1:1400 N SEMORAN BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3536
Mailing Address - Country:US
Mailing Address - Phone:407-823-8421
Mailing Address - Fax:407-823-8195
Practice Address - Street 1:1400 N SEMORAN BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3536
Practice Address - Country:US
Practice Address - Phone:407-823-8421
Practice Address - Fax:407-823-8195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000143660251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health