Provider Demographics
NPI:1851084834
Name:COMPASSIONATE PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:COMPASSIONATE PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-837-0538
Mailing Address - Street 1:77 THEODORE DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-9162
Mailing Address - Country:US
Mailing Address - Phone:207-837-0538
Mailing Address - Fax:844-640-0624
Practice Address - Street 1:77 THEODORE DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-9162
Practice Address - Country:US
Practice Address - Phone:207-837-0538
Practice Address - Fax:844-640-0624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty