Healthcare Provider Details

I. General information

NPI: 1093186363
Provider Name (Legal Business Name): COMPASS COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 RIVERCREST DR
SYLVA NC
28779-8774
US

IV. Provider business mailing address

85 RIVERCREST DR
SYLVA NC
28779-8774
US

V. Phone/Fax

Practice location:
  • Phone: 919-807-1453
  • Fax:
Mailing address:
  • Phone: 919-807-1453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC009302
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MARY KATHERINE CRISP
Title or Position: MEMBER
Credential: MSW, LCSW, LCASA
Phone: 919-807-1453