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General NPI Number Information
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NPI Number | 1508488776
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Entity Type | Individual
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Provider Name | ELEN REDFORD CRC, LPC, LCDC
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Gender | Female
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 6401 ELDORADO PKWY STE 304
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City | MCKINNEY
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State | TX
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Zip | 75070-6199
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Country | US
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Telephone | 972-656-9412
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Fax |
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Provider Business Mailing Address
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Address Line | 912 E STANDIFER ST
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City | MCKINNEY
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State | TX
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Zip | 75069-5853
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Country | US
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Telephone | 972-838-8200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 14739
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 79078
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License Number State | TX
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