REDEEM WELLNESS CENTER LLC NPI 1144876392

NPI Information

NPI: 1144876392
Provider Name: REDEEM WELLNESS CENTER, LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
3180 MAIN ST STE 106
BRIDGEPORT, CT
ZIP 06606
Phone: (203) 208-3940
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REDEEM WELLNESS CENTER, LLC is a mental health counselor in Bridgeport, CT. REDEEM WELLNESS CENTER, LLC NPI is 1144876392. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3180 MAIN ST STE 106
BRIDGEPORT, CT
ZIP 06606-237
Phone: (203) 208-3940
Fax: (203) 372-3272

The provider's authorized official is Grace Cullen .
The authorized official title is Medical Billing Manager and has the following contact phone number (203) 368-5515.

The enumeration date for this NPI number is 8/14/2019 and was last updated on 9/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	106H00000X	Marriage & Family Therapist				No
2	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	004069985	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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