Provider Demographics
NPI:1962832758
Name:COMPASSIONATE COUNSELING CENTER
Entity Type:Organization
Organization Name:COMPASSIONATE COUNSELING CENTER
Other - Org Name:JULIE RUSSELL FAMILY COUSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MFT, PC
Authorized Official - Phone:503-312-9163
Mailing Address - Street 1:11740 SW WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8459
Mailing Address - Country:US
Mailing Address - Phone:503-312-9163
Mailing Address - Fax:
Practice Address - Street 1:11740 SW WARNER AVE
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8459
Practice Address - Country:US
Practice Address - Phone:503-312-9163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health