Provider Demographics
NPI:1215497680
Name:SMITH'S COMPASS COUNTRY COUNSELING
Entity type:Organization
Organization Name:SMITH'S COMPASS COUNTRY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:812-604-8864
Mailing Address - Street 1:10320 E MARIA CT
Mailing Address - Street 2:
Mailing Address - City:CELESTINE
Mailing Address - State:IN
Mailing Address - Zip Code:47521-9600
Mailing Address - Country:US
Mailing Address - Phone:812-604-8864
Mailing Address - Fax:
Practice Address - Street 1:10320 E MARIA CT
Practice Address - Street 2:
Practice Address - City:CELESTINE
Practice Address - State:IN
Practice Address - Zip Code:47521-9600
Practice Address - Country:US
Practice Address - Phone:812-604-8864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty