Provider Demographics
NPI:1053108142
Name:COMPASS FAMILY THERAPY LLC
Entity type:Organization
Organization Name:COMPASS FAMILY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRUETT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:850-345-3207
Mailing Address - Street 1:1800 VINELAND LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-7924
Mailing Address - Country:US
Mailing Address - Phone:850-345-3207
Mailing Address - Fax:
Practice Address - Street 1:2065 DELTA WAY STE 1
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4242
Practice Address - Country:US
Practice Address - Phone:850-345-3207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health