CONSUELO REDDICK (NPI# 1437214350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 00024706 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
3133 N Millbrook Ave, Fresno, CA 937031425 | 5596008918 | 5596007701 |
Street Address |
77 E CROSSVILLE RD STE. 206 |
City | ROSWELL |
State | GA |
Zip Code | 30075-5815 |
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 |
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 |
Find all providers in zip 30075 |
Taxonomy Code | 2084P0804X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Child & Adolescent Psychiatry |
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] |
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 |
Find all providers with the same taxonomy |
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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.