Provider Demographics
NPI:1225623069
Name:COMPASSIONATE CONNECTIONS
Entity Type:Organization
Organization Name:COMPASSIONATE CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JADORA
Authorized Official - Middle Name:BREAL
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:502-296-6734
Mailing Address - Street 1:1603 AVERY LN
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-4189
Mailing Address - Country:US
Mailing Address - Phone:502-296-6734
Mailing Address - Fax:
Practice Address - Street 1:214 BRECKENRIDGE LN STE 205
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3879
Practice Address - Country:US
Practice Address - Phone:502-296-6734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty