Healthcare Provider Details

I. General information

NPI: 1609505023
Provider Name (Legal Business Name): ANDREA ELIZABETH REDD LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 E COLORADO BLVD STE 180&2ND
PASADENA CA
91101-6143
US

IV. Provider business mailing address

PO BOX 654
SUWANEE GA
30024-0654
US

V. Phone/Fax

Practice location:
  • Phone: 951-428-4140
  • Fax:
Mailing address:
  • Phone: 619-988-5063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: