Provider Demographics
NPI:1477195832
Name:COMPASS FOR LIFE - INDIVIDUAL AND FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:COMPASS FOR LIFE - INDIVIDUAL AND FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHALLENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-399-8147
Mailing Address - Street 1:1013 HARBOR BLVD # 8
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-1131
Mailing Address - Country:US
Mailing Address - Phone:818-399-8147
Mailing Address - Fax:
Practice Address - Street 1:119 FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2756
Practice Address - Country:US
Practice Address - Phone:818-399-8147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2020-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty