Provider Demographics
NPI:1124374616
Name:RECONNECTIONS, LLC
Entity type:Organization
Organization Name:RECONNECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BRETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-614-9485
Mailing Address - Street 1:255 EVERNIA ST APT 919
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5686
Mailing Address - Country:US
Mailing Address - Phone:436-149-4854
Mailing Address - Fax:
Practice Address - Street 1:255 EVERNIA ST APT 919
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5686
Practice Address - Country:US
Practice Address - Phone:443-614-9485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MD102571041C0700X
MDD02126133V00000X
MDN00206133V00000X
MDLC1964101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty