Healthcare Provider Details
I. General information
NPI: 1376351882
Provider Name (Legal Business Name): COMPASSION COMPASS THERAPY LICENSED CLINICAL SOCIAL WORKER PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/30/2024
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3590 CENTRAL AVE STE 201
RIVERSIDE CA
92506-2708
US
IV. Provider business mailing address
3590 CENTRAL AVE STE 201
RIVERSIDE CA
92506-2708
US
V. Phone/Fax
- Phone: 951-363-3787
- Fax:
- Phone: 951-363-3787
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEAHMONTAINE
S
BARROW
Title or Position: CEO/ PRESIDENT
Credential: LCSW
Phone: 951-363-3787