MEDICARE: COMPASS PSYCHOLOGICAL TESTING AND EVALUATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1952095945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASS PSYCHOLOGICAL TESTING AND EVALUATION

Provider Business Mailing Address
First Line	:	150 E BECK ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43206-1113
Country	:	US
Telephone Number	:	317-363-9448
Fax Number	:

Provider Business Practice Location Address
First Line	:	4131 WORTH AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-6282
Country	:	US
Telephone Number	:	614-515-2663
Fax Number	:

Authorized Official
Title or Position	:	OWNER; CLINICAL PSYCHOLOGIST
Name	:	HALEY BRICKMAN
Credential	:	PHD
Telephone Number	:	614-515-2663

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	06/05/2023

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