Provider Demographics
NPI:1003161928
Name:RECONNECT CONSULTING INC
Entity Type:Organization
Organization Name:RECONNECT CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:AH
Authorized Official - Last Name:DARNALL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:904-322-0070
Mailing Address - Street 1:3955 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-3312
Mailing Address - Country:US
Mailing Address - Phone:904-483-3843
Mailing Address - Fax:
Practice Address - Street 1:3955 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-3312
Practice Address - Country:US
Practice Address - Phone:904-483-3843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL108391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty