Healthcare Provider Details

I. General information

NPI: 1114830924
Provider Name (Legal Business Name): REDEEMED MIND COUNSELING GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 JUDSON RD STE 140
LONGVIEW TX
75601-5119
US

IV. Provider business mailing address

1121 JUDSON RD STE 140
LONGVIEW TX
75601-5119
US

V. Phone/Fax

Practice location:
  • Phone: 903-423-0833
  • Fax:
Mailing address:
  • Phone: 903-423-0833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARIA DOLORES RIVERA
Title or Position: OWNER
Credential: LPC
Phone: 903-423-0833