Provider Demographics
NPI:1649834565
Name:COMPASSIONATE HEALING COUNSELING SERVICE, LLC
Entity type:Organization
Organization Name:COMPASSIONATE HEALING COUNSELING SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:812-431-2710
Mailing Address - Street 1:9214 JILLIAN CT
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-5409
Mailing Address - Country:US
Mailing Address - Phone:812-431-2710
Mailing Address - Fax:812-602-3664
Practice Address - Street 1:600 N WEINBACH AVE STE 720
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-5977
Practice Address - Country:US
Practice Address - Phone:812-602-3663
Practice Address - Fax:812-602-3664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)