Healthcare Provider Details

I. General information

NPI: 1144039462
Provider Name (Legal Business Name): RED CEDAR PSYCHOTHERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2025
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 MAYFIELD DR STE 206
SMYRNA TN
37167-3026
US

IV. Provider business mailing address

240 MAYFIELD DR STE 206
SMYRNA TN
37167-3026
US

V. Phone/Fax

Practice location:
  • Phone: 615-994-1314
  • Fax: 615-909-4450
Mailing address:
  • Phone: 615-994-1314
  • Fax: 615-909-4450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL RENEE' OWENS
Title or Position: OWNER
Credential: LPC-MHSP
Phone: 615-994-1314