Provider Demographics
NPI:1326806258
Name:NEURONNECTION COUNSELING, PLLC
Entity Type:Organization
Organization Name:NEURONNECTION COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYRIAM
Authorized Official - Middle Name:DANIELLE JEANNE
Authorized Official - Last Name:RABASTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:704-906-7575
Mailing Address - Street 1:7418 CROSS TIE CT
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-1437
Mailing Address - Country:US
Mailing Address - Phone:704-906-7575
Mailing Address - Fax:
Practice Address - Street 1:7418 CROSS TIE CT
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-1437
Practice Address - Country:US
Practice Address - Phone:704-906-7575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health