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General NPI Number Information
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NPI Number | 1124374616
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Entity Type | Organization
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Legal Business Name | RECONNECTIONS, LLC
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 11/19/2021
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Provider Practice Location Address
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Address Line | 255 EVERNIA ST APT 919
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5686
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Country | US
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Telephone | 443-614-9485
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Fax |
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Provider Business Mailing Address
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Address Line | 255 EVERNIA ST APT 919
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5686
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Country | US
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Telephone | 436-149-4854
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELINDA JO BRETT
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Credential | LCPC
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Telephone | 443-614-9485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10257
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | D02126
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | N00206
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC1964
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License Number State | MD
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