Provider Demographics
NPI:1861077612
Name:COMPASSIONATE HEART COUNSELING
Entity type:Organization
Organization Name:COMPASSIONATE HEART COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:925-226-8780
Mailing Address - Street 1:640 BAILEY RD # 482
Mailing Address - Street 2:
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565-4306
Mailing Address - Country:US
Mailing Address - Phone:925-226-8780
Mailing Address - Fax:925-528-4565
Practice Address - Street 1:2225 BUCHANAN RD STE H
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4209
Practice Address - Country:US
Practice Address - Phone:925-226-8780
Practice Address - Fax:925-528-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty