Healthcare Provider Details

I. General information

NPI: 1104763788
Provider Name (Legal Business Name): ORIN R REDMOND LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 PROFESSIONAL DR STE E
MYRTLE BEACH SC
29577-5712
US

IV. Provider business mailing address

1304 PROFESSIONAL DR STE E
MYRTLE BEACH SC
29577-5712
US

V. Phone/Fax

Practice location:
  • Phone: 843-894-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00523000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12048
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: