Provider Demographics
NPI:1720809957
Name:BOUND 2 CONNECT MINISTRIES, INC.
Entity type:Organization
Organization Name:BOUND 2 CONNECT MINISTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:REKITA
Authorized Official - Middle Name:DANYALLE
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LPASTC
Authorized Official - Phone:757-660-0515
Mailing Address - Street 1:152 SECRETARIAT DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-1786
Mailing Address - Country:US
Mailing Address - Phone:757-660-0515
Mailing Address - Fax:
Practice Address - Street 1:152 SECRETARIAT DR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-1786
Practice Address - Country:US
Practice Address - Phone:757-660-0515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty