REDEEM WELLNESS CENTER, LLC (NPI# 1144876392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144876392 |
| Entity Type | Organization |
| Organization Name | REDEEM WELLNESS CENTER, LLC |
| Practice Address |
3180 Main St Ste 106 Bridgeport CT 06606-4237 |
| Mailing Address |
6405 Camden Rd Fayetteville NC 28306-7216 |
| Practice Telephone | 2032083940 |
| Practice Fax Number | 2033723272 |
| Mailing Telephone | 9102755766 |
| Mailing Fax Number | 8335960382 |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | GRACE CULLEN (MEDICAL BILLING MANAGER) |
| Authorized Official Telephone | 2033685515 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004069985 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6405 Camden Rd, Fayetteville, NC 283067216 | 9102755766 | 8335960382 |
| Street Address |
3180 MAIN ST STE 106 |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06606-4237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962023408 | Madeline Acquilano | Pharmacist | 2800 East Main St, Bridgeport, CT 06606 | 2020-05-06 |
| 1578192001 | Karin Alexandra Skalina | Student in an Organized Health Care Education/Training Program | 2800 Main St., Dept. of Medicine, Bridgeport, CT 06606 | 2020-04-06 |
| 1720641293 | Valeriia Klymenko | Student in an Organized Health Care Education/Training Program | 2800 Main Street, Department of Medicine, Bridgeport, CT 06606 | 2019-04-19 |
| 1821579996 | Ashley Liese | Nurse Practitioner | Cardiology Physicians of Fairfield County, 2679 Main St, Bridgeport, CT 06606 | 2018-08-27 |
| 1699261289 | Gema Estefania Giler-sacoto | Student in an Organized Health Care Education/Training Program | St. Vincent's Medical Center, 2800 Main Street, Department of Medicine, Bridgeport, CT 06606 | 2018-07-06 |
| 1114418365 | Jona Bumci | Physician Assistant | 3180 Main St Ste 304, Bridgeport, CT 06606 | 2018-05-23 |
| 1023471299 | Qmg4, LLC | Family Medicine | 4200 Main Street, Bridgeport, CT 06606 | 2016-04-04 |
| 1861867442 | Marie Dorothea Lisieski | Social Worker | 2400 Main Street, Bridgeport, CT 06606 | 2015-12-08 |
| 1548603384 | Gerald E. Hedley | Internal Medicine | 390 Charles Street Unit #101, Bridgeport, CT 06606 | 2013-04-11 |
| 1487997581 | Gerald Micalizzi, M.d., LLC | Radiology | 558 Fairview Avenue, Bridgeport, CT 06606 | 2013-03-27 |
| Find all providers in zip 06606 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528666955 | Emily Mariah Wolf | Counselor | 1154 Walnut Grove Rd, Bridgeport, NY 13030-9760 | 2020-10-16 |
| 1437760071 | Danielle Gofman | Counselor | 2675 Park Ave Unit 29, Bridgeport, CT 06604-1356 | 2020-08-16 |
| 1134691868 | Margaret Katherine Leska | Counselor | 180 Fairfield Ave # 1, Bridgeport, CT 06604-4252 | 2018-12-19 |
| 1124595772 | Julia Frank | Counselor | 4699 Main St Ste 105, Bridgeport, CT 06606-1830 | 2018-10-31 |
| 1801267265 | Zachary Grill | Counselor | 123 Gilman St, Bridgeport, CT 06605-3314 | 2015-10-12 |
| 1992185102 | Juliet Jacob | Counselor | 3250 Fairfield Ave Apt 317, Bridgeport, CT 06605-3273 | 2015-06-02 |
| 1477958080 | Luis Alejandro Castellon Jr. | Counselor | 121 Frank St, Bridgeport, CT 06604-3202 | 2014-10-24 |
| 1669877379 | Devana Campbell | Counselor | 15 Heritage Pl, Bridgeport, CT 06606-1314 | 2014-10-24 |
| 1760887475 | Pryndall Marie White | Counselor | 955 Main St Apt 906, Bridgeport, CT 06604-4319 | 2014-10-24 |
| 1669744611 | Tdat Transitional Development and Training | Counselor | 70 Lincoln Blvd, Bridgeport, CT 06606-5550 | 2012-02-07 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06606 |
Please comment or provide details below to improve the information on REDEEM WELLNESS CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.