=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942589254
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMPASS COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2011
-----------------------------------------------------
Last Update Date | 08/04/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4957 BIG LAKE RD
-----------------------------------------------------
City | LAKE CHARLES
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70605-6739
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-477-0708
-----------------------------------------------------
Fax | 337-477-0508
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4957 BIG LAKE RD
-----------------------------------------------------
City | LAKE CHARLES
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70605-6739
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-477-0708
-----------------------------------------------------
Fax | 337-477-0508
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED PROFESSIONAL COUNSELOR
-----------------------------------------------------
Name | MR. CHRISTOPHER K HAY
-----------------------------------------------------
Credential | M.ED, LPC, LMFT
-----------------------------------------------------
Telephone | 337-477-0708
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 226
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 2338
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------