Provider Demographics
NPI:1780290361
Name:COMPASSIONATE PEER COUNSELING LLC
Entity type:Organization
Organization Name:COMPASSIONATE PEER COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PEER COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:SCALZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-486-4921
Mailing Address - Street 1:1800 S JACKSON ST APT 242
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2182
Mailing Address - Country:US
Mailing Address - Phone:206-486-4921
Mailing Address - Fax:
Practice Address - Street 1:3250 AIRPORT WAY S STE 608
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-2172
Practice Address - Country:US
Practice Address - Phone:206-486-4921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-19
Last Update Date:2020-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty