Provider Demographics
NPI:1265143028
Name:REUNITE, LLC
Entity type:Organization
Organization Name:REUNITE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOTOP
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-660-7303
Mailing Address - Street 1:12430 TESSON FERRY RD STE 206
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2702
Mailing Address - Country:US
Mailing Address - Phone:512-660-7303
Mailing Address - Fax:
Practice Address - Street 1:10922 SCHUETZ RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5704
Practice Address - Country:US
Practice Address - Phone:512-660-7303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1376250357OtherNPI