Healthcare Provider Details

I. General information

NPI: 1477078160
Provider Name (Legal Business Name): COMPASS COMMUNITY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 E MCLOUGHLIN BLVD
VANCOUVER WA
98663-3358
US

IV. Provider business mailing address

613 E MCLOUGHLIN BLVD
VANCOUVER WA
98663-3358
US

V. Phone/Fax

Practice location:
  • Phone: 360-828-5350
  • Fax:
Mailing address:
  • Phone: 360-828-5350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARISSA ANN TALARICO
Title or Position: CO-OWNER/THERAPIST
Credential: LMFTA
Phone: 360-828-5350