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General NPI Number Information
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NPI Number | 1780122168
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Entity Type | Organization
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Legal Business Name | COMPASS COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 3575 FOREST LAKE DR STE 100
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City | UNIONTOWN
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State | OH
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Zip | 44685-8115
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Country | US
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Telephone | 330-949-7043
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Fax |
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Provider Business Mailing Address
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Address Line | 3575 FOREST LAKE DR STE 100
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City | UNIONTOWN
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State | OH
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Zip | 44685-8115
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Country | US
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Telephone | 330-949-7043
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CRYSTAL D HINER
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Credential | PCCS/LICDC
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Telephone | 330-949-7043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LICDC.111039
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LICDC121025
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E0900626SUPV
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E0900175 SUPV
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License Number State | OH
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