Healthcare Provider Details

I. General information

NPI: 1205740529
Provider Name (Legal Business Name): COMPASSION CONNEXION COMMUNITY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 HUNTSMAN RD
SANDSTON VA
23150-2238
US

IV. Provider business mailing address

738 HUNTSMAN RD
SANDSTON VA
23150-2238
US

V. Phone/Fax

Practice location:
  • Phone: 804-908-6685
  • Fax: 804-800-2446
Mailing address:
  • Phone: 804-908-6685
  • Fax: 804-800-2446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. NICOLE DOMONIQUE COOK-BROGDON
Title or Position: OWNER/CEO
Credential: LCSW, MSHA
Phone: 804-908-6685