Provider Demographics
NPI:1891123956
Name:COMPASS COUNSELING AND ASSESSMENTS INC.,
Entity Type:Organization
Organization Name:COMPASS COUNSELING AND ASSESSMENTS INC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:605-520-0157
Mailing Address - Street 1:PO BOX 1131
Mailing Address - Street 2:1805 NORTHRIDGE DRIVE
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201
Mailing Address - Country:US
Mailing Address - Phone:605-520-0157
Mailing Address - Fax:
Practice Address - Street 1:103 19TH ST NE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-2823
Practice Address - Country:US
Practice Address - Phone:605-520-0157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-28
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2210251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health