MEDICARE: COMPASSIONATE COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LH60118130	WA
2	101YM0800X	Mental Health Counselor	LH60051192	WA

General Provider Information

NPI Number	:	1063724953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE COUNSELING

Provider Business Mailing Address
First Line	:	PO BOX 93
Second Line	:
City	:	UNDERWOOD
State	:	WA
Zip	:	98651-0093
Country	:	US
Telephone Number	:	541-980-1919
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 W STEUBEN
Second Line	:
City	:	BINGEN
State	:	WA
Zip	:	98605
Country	:	US
Telephone Number	:	509-493-1143
Fax Number	:

Authorized Official
Title or Position	:	LICENSED MENTAL HEALTH COUNSELOR
Name	:	SARAH DAVIS OAKS
Credential	:	M.S.
Telephone Number	:	509-493-1143

Provider Enumeration Date	:	07/08/2010
Last Update Date	:	07/08/2010

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