Provider Demographics
NPI:1891178604
Name:COMPASS COUNSELING ASSOCIATES LLC
Entity Type:Organization
Organization Name:COMPASS COUNSELING ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:239-495-7773
Mailing Address - Street 1:9180 ESTERO PARK COMMONS BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-3218
Mailing Address - Country:US
Mailing Address - Phone:239-495-7773
Mailing Address - Fax:239-495-7772
Practice Address - Street 1:9180 ESTERO PARK COMMONS BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-3218
Practice Address - Country:US
Practice Address - Phone:239-495-7773
Practice Address - Fax:239-495-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4973101YM0800X
FLMH 13294101YM0800X
FLMH13028101YM0800X
FLMT 1928106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty