Provider Demographics
NPI:1104404805
Name:COMPASSION COUNSELING PLLC
Entity type:Organization
Organization Name:COMPASSION COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LMFT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JIANAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:208-557-1517
Mailing Address - Street 1:1970 E 17TH ST STE 111A
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-8046
Mailing Address - Country:US
Mailing Address - Phone:208-557-1517
Mailing Address - Fax:
Practice Address - Street 1:1970 E 17TH ST STE 111A
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-8046
Practice Address - Country:US
Practice Address - Phone:208-557-1517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)