Provider Demographics
NPI:1871283101
Name:COMPASSION FOR THE MIND
Entity type:Organization
Organization Name:COMPASSION FOR THE MIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGROVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-874-7851
Mailing Address - Street 1:211 S STATE COLLEGE BLVD # 1057
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-4116
Mailing Address - Country:US
Mailing Address - Phone:661-463-0493
Mailing Address - Fax:
Practice Address - Street 1:211 S STATE COLLEGE BLVD # 1057
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-4116
Practice Address - Country:US
Practice Address - Phone:661-874-7851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty