Provider Demographics
NPI:1598537565
Name:NEUROCONNECT AUTISTIC MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:NEUROCONNECT AUTISTIC MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-610-7880
Mailing Address - Street 1:8641 SANDY RD NE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-9345
Mailing Address - Country:US
Mailing Address - Phone:360-610-7880
Mailing Address - Fax:
Practice Address - Street 1:8641 SANDY RD NE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-9345
Practice Address - Country:US
Practice Address - Phone:360-610-7880
Practice Address - Fax:360-824-5440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty