MEDICARE: JOHN H REDDEN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC 1597	TN

General Provider Information

NPI Number	:	1821184805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN H REDDEN LPC

Provider Business Mailing Address
First Line	:	115 LAURIE CIR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-3046
Country	:	US
Telephone Number	:	731-697-7733
Fax Number	:

Provider Business Practice Location Address
First Line	:	367B N PARKWAY STE 1
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2899
Country	:	US
Telephone Number	:	731-668-2277
Fax Number	:	731-660-0510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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Directions to “ JOHN H REDDEN LPC” Practice Location

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