Provider Demographics
NPI:1861852907
Name:COMPASS MENTAL HEALTH CONSULTANTS, LLC
Entity Type:Organization
Organization Name:COMPASS MENTAL HEALTH CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PERRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-551-2455
Mailing Address - Street 1:1762 SEA PINE CIR
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-1815
Mailing Address - Country:US
Mailing Address - Phone:410-551-2455
Mailing Address - Fax:866-422-6096
Practice Address - Street 1:11140 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 400
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3106
Practice Address - Country:US
Practice Address - Phone:240-630-4048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD215391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty