Healthcare Provider Details

I. General information

NPI: 1528640323
Provider Name (Legal Business Name): COMPASS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 W 11TH ST
KEARNEY NE
68845-7336
US

IV. Provider business mailing address

514 W 11TH ST
KEARNEY NE
68845-7336
US

V. Phone/Fax

Practice location:
  • Phone: 308-237-4085
  • Fax: 308-224-3864
Mailing address:
  • Phone: 308-237-4085
  • Fax: 308-224-3864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALISA JO RYAN
Title or Position: CLINICAL DIRECTOR
Credential: LMHP
Phone: 308-237-4085