Healthcare Provider Details

I. General information

NPI: 1336737238
Provider Name (Legal Business Name): COMPASS SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 MCCLURE AVE
NAMPA ID
83651-2025
US

IV. Provider business mailing address

2357 HAW CREEK BLVD
EMMETT ID
83617-9601
US

V. Phone/Fax

Practice location:
  • Phone: 208-871-4858
  • Fax:
Mailing address:
  • Phone: 208-278-8942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASON JOHNSON
Title or Position: OWNER
Credential: LCSW
Phone: 208-994-6458