Healthcare Provider Details

I. General information

NPI: 1679689673
Provider Name (Legal Business Name): DOLORES THERESE REDDICK LCSW, LCDC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOLORES THERESE GARCIA LCSW, LCDC

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4415 W PIEDRAS DR SUITE 208
SAN ANTONIO TX
78228-1216
US

IV. Provider business mailing address

10414 ROCKING M TRL
HELOTES TX
78023-4033
US

V. Phone/Fax

Practice location:
  • Phone: 210-733-9929
  • Fax: 210-733-9916
Mailing address:
  • Phone: 210-421-7779
  • Fax: 210-733-9916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6460
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number27629
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27629
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: