Provider Demographics
NPI:1821856907
Name:COMPASSION COUCH THERAPY LLC
Entity Type:Organization
Organization Name:COMPASSION COUCH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMONDO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:224-777-0570
Mailing Address - Street 1:848 DODGE AVE.
Mailing Address - Street 2:PO BOX 368
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202
Mailing Address - Country:US
Mailing Address - Phone:224-777-0570
Mailing Address - Fax:
Practice Address - Street 1:2012 BRUMMEL ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3606
Practice Address - Country:US
Practice Address - Phone:224-777-0570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty