Healthcare Provider Details

I. General information

NPI: 1770857922
Provider Name (Legal Business Name): COMPASSION COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 03/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 KIMBERLY RD SUITE 155
BETTENDORF IA
52722-3509
US

IV. Provider business mailing address

2435 KIMBERLY RD SUITE 155
BETTENDORF IA
52722-3509
US

V. Phone/Fax

Practice location:
  • Phone: 563-359-7625
  • Fax: 563-459-0494
Mailing address:
  • Phone: 563-359-7625
  • Fax: 563-459-0494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberW00776367
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberW00776367
License Number StateIA

VIII. Authorized Official

Name: MRS. JANET L HUBER
Title or Position: PRESIDENT
Credential:
Phone: 563-359-7625