Provider Demographics
NPI:1962041350
Name:COMPASS ROSE COUNSELING, LLC
Entity Type:Organization
Organization Name:COMPASS ROSE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-582-3003
Mailing Address - Street 1:44 E SPAULDING AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-1668
Mailing Address - Country:US
Mailing Address - Phone:719-582-3003
Mailing Address - Fax:866-286-8545
Practice Address - Street 1:44 E SPAULDING AVE STE 1
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-1668
Practice Address - Country:US
Practice Address - Phone:719-582-3003
Practice Address - Fax:866-286-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-02
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)