Provider Demographics
NPI:1962798116
Name:COMPASS ROSE COUNSELING LLC
Entity type:Organization
Organization Name:COMPASS ROSE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PILAFAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:706-817-1951
Mailing Address - Street 1:622 CARRIAGE LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:GA
Mailing Address - Zip Code:30650-1750
Mailing Address - Country:US
Mailing Address - Phone:706-817-1951
Mailing Address - Fax:
Practice Address - Street 1:622 CARRIAGE LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:GA
Practice Address - Zip Code:30650-1750
Practice Address - Country:US
Practice Address - Phone:706-817-1951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0042391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty