NPIMap

Organization Active NPI

Compass Counseling Services PLLC

  • Clinical Social Worker
  • Fort Gibson, OK
National Provider Identifier
1346724747
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
COMPASS COUNSELING SERVICES PLLC
Practice address
908 S Lee St Ste a
Fort Gibson, OK 74434-8735
Phone
(903) 715-2004
Fax
(918) 203-3116
NPI assigned
Sep 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Alec Storm Moreno, LMSW, LCSWNPI 1568884666
Title
Owner
Phone
(903) 715-2004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

908 S Lee St Ste a
Fort Gibson, OK 74434-8735

Mailing address

PO Box 776
Fort Gibson, OK 74434-0776
Phone (903) 715-2004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191101000332 OK Part B Supplier - Clinic/Group Practice 2264764794 Receives reassigned benefits from 7 practitioners
Practice locations: Fort Gibson, OK

National Provider Directory

National Provider Directory

Locations

908 S Lee St
Ste A
Fort Gibson, OK 74434
Phone (918) 203-3789

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1346724747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744340776",
            "telephone_number": "903-715-2004",
            "fax_number": "918-203-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 S LEE ST STE A",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744348735",
            "telephone_number": "903-715-2004",
            "fax_number": "918-203-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "ALEC",
        "authorized_official_middle_name": "STORM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-715-2004",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gibson, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.