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General NPI Number Information
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NPI Number | 1518328632
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Entity Type | Organization
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Legal Business Name | COMPASS COUNSELING LLC
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 105 N 3RD ST STE 6
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City | WEST BRANCH
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State | MI
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Zip | 48661-1265
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Country | US
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Telephone | 989-965-2465
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 608
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City | WEST BRANCH
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State | MI
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Zip | 48661-0608
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Country | US
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Telephone | 989-965-2465
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Fax |
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | LISA JANE GUTIERREZ
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Credential | LMSW
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Telephone | 989-965-2465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801093836
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License Number State | MI
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