Provider Demographics
NPI:1740933704
Name:COMPASS COUNSELING OF NORTHWEST INDIANA, LLC
Entity type:Organization
Organization Name:COMPASS COUNSELING OF NORTHWEST INDIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC
Authorized Official - Phone:219-286-3605
Mailing Address - Street 1:57 MICHIGAN AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-5393
Mailing Address - Country:US
Mailing Address - Phone:219-286-3605
Mailing Address - Fax:
Practice Address - Street 1:57 MICHIGAN AVE STE 203
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-5393
Practice Address - Country:US
Practice Address - Phone:407-408-7268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty