Healthcare Provider Details

I. General information

NPI: 1841575107
Provider Name (Legal Business Name): COMPASS HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1839 PEARL RD
BRUNSWICK OH
44212-3256
US

IV. Provider business mailing address

1839 PEARL RD
BRUNSWICK OH
44212-3256
US

V. Phone/Fax

Practice location:
  • Phone: 440-554-6443
  • Fax:
Mailing address:
  • Phone: 440-554-6443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE 0008350
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE 0004235
License Number StateOH

VIII. Authorized Official

Name: MR. CHADWICK SUNDAY
Title or Position: MENTAL HEALTH THERAPIST
Credential: MA,LPCC-S
Phone: 440-554-6443