Healthcare Provider Details

I. General information

NPI: 1689889396
Provider Name (Legal Business Name): COMPASSION COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 03/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590-01 CONSTITUTION BLVD BLDG C
ROCK HILL SC
29732-3004
US

IV. Provider business mailing address

PO BOX 37652
ROCK HILL SC
29732-0528
US

V. Phone/Fax

Practice location:
  • Phone: 803-329-6161
  • Fax: 803-328-8840
Mailing address:
  • Phone: 803-329-6161
  • Fax: 803-328-8840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number325
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number158
License Number StateSC

VIII. Authorized Official

Name: JAMES R. MCSPADDEN JR.
Title or Position: CSW
Credential:
Phone: 803-329-6161