CONSUELO REDDICK


Address: 77 E Crossville Rd, Ste. 206, Roswell, GA 30075-5815
Phone: 7705524655

CONSUELO REDDICK (NPI# 1437214350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437214350
Entity Type Individual
Full Name CONSUELO REDDICK
Credential M.D.
Practice Address 77 E Crossville Rd
Ste. 206
Roswell
GA 30075-5815
Mailing Address Po Box 1988
Roswell
GA 30077-1988
Practice Telephone 7705524655
Practice Fax Number 7705524282
Mailing Telephone 7706624655
Mailing Fax Number 7705524282
Enumeration Date 2006-12-22
Last Update Date 2019-06-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2084P0800X Psychiatry & Neurology
Specialization: Psychiatry
G133049 CA Allopathic & Osteopathic Physicians
N 2084P0800X Psychiatry & Neurology
Specialization: Psychiatry
044067 GA Allopathic & Osteopathic Physicians
N 2084P0804X Psychiatry & Neurology
Specialization: Child & Adolescent Psychiatry
G133049 CA Allopathic & Osteopathic Physicians
Y 2084P0804X Psychiatry & Neurology
Specialization: Child & Adolescent Psychiatry
044067 GA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
GA 00024706 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
3133 N Millbrook Ave, Fresno, CA 937031425 5596008918 5596007701

Office Location

Street Address 77 E CROSSVILLE RD
STE. 206
City ROSWELL
State GA
Zip Code 30075-5815

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457691156 Soul Care Counselor 77 E Crossville Rd, Suite 207, Roswell, GA 30075-5815 2013-02-18
1528303906 Terry Mitchell Counselor 77 E Crossville Rd, #207, Roswell, GA 30075-5815 2012-12-11
1114251188 Roswell Psychiatric Services, PC Psychiatry & Neurology 77 E Crossville Rd, Ste. 206, Roswell, GA 30075-5815 2009-09-24

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851889539 William Shelton Green Specialist/Technologist 1055 Riceland Ct, Roswell, GA 30075 2018-04-27
1043712524 Lena Claire Morison Music Therapist 12060 Etris Rd. #200, Roswell, GA 30075 2018-03-01
1790232031 Christina Danielle Dicioccio Physician Assistant 11040 Crabapple Rd # Suiea, Roswell, GA 30075 2016-09-02
1720531767 Arbor Cove Therapy LLC Social Worker 981 Canton St, Suite 200-e, Roswell, GA 30075 2016-07-26
1740640887 Christina C Plaice Counselor 10882 Crabapple Road, Suite 2, Roswell, GA 30075 2016-03-02
1215316435 Jlm X-ray LLC Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 1015 Canton Street, Roswell, GA 30075 2015-05-20
1174953624 Ellen Terrell Occupational Therapist 10050 Crabapple Road, Suite D-115a, Roswell, GA 30075 2013-11-20
1114269974 Patricia E Hernandez Nurse Practitioner 10479 Alpharetta St Ste 18, Roswell, GA 30075 2013-03-20
1750623658 The George Center Foundation Music Therapist 1206 Etris Rd., Suite 200, Roswell, GA 30075 2013-03-19
1407187735 Rachael Anne Templeton Chiropractor 593 Atlanta Street, Gorman Chiropractic, Roswell, GA 30075 2010-01-27
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Taxonomy Information

Taxonomy Code 2084P0804X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Child & Adolescent Psychiatry

Taxonomy Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1205468840 Angela Leigh Eubanks Psychiatry & Neurology 11 S Winston St, Reynolds, GA 31076-3200 2020-02-11
1265064364 Haven Psychiatry, LLC Psychiatry & Neurology 5871 Glenridge Dr Ste 220, Atlanta, GA 30328-5305 2020-02-06
1760953434 David S Deuser Md & Associates PC Psychiatry & Neurology 7 Saint Andrews Court, Brunswick, GA 31520 2018-12-06
1093249393 Healing for All LLC Psychiatry & Neurology 3307 Sir Henry St, East Point, GA 30344-5831 2017-04-13
1699216416 Abva, Inc Psychiatry & Neurology 4565 Rockmart Rd Se, Unit 1261, Silver Creek, GA 30173-2442 2017-03-13
1225436017 Aatma Seva Health Inc Psychiatry & Neurology 523 Dixie St Ste 3, Carrollton, GA 30117-3870 2014-12-11
1619309309 Howel William Slaughter Jr. Psychiatry & Neurology 40 Abington Ct Nw, Atlanta, GA 30327-1352 2013-08-05
1427493568 Susan Kirsch Psychiatry & Neurology 7000 Peachtree Dunwoody Rd Bldg 16, Atlanta, GA 30328-1655 2013-05-02
1023362852 Rivertown Psychiatry, PC Psychiatry & Neurology 1520 22nd Street, Columbus, GA 31901-1632 2012-10-31
1548550429 Bene' Mental Wellness Psychiatry & Neurology 1835 Savoy Dr Ste 101, Atlanta, GA 30341-1073 2011-04-13
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Competitor

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City ROSWELL
Zip Code 30075

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Dataset Information

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.

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