Madeline Chiarella Redetzky, MS, LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC013132 Issued in GA

Practice address

2750 Old Alabama Rd Ste 200
Johns Creek, GA 30022

Phone

(678) 893-5300

NPI assigned

Dec 10, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Summit Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Johns Creek, GA
  • NPI 1477761633
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1295372175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 OLD ALABAMA RD STE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228553",
            "telephone_number": "678-893-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 OLD ALABAMA RD STE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "30022",
            "telephone_number": "678-893-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDETZKY",
        "first_name": "MADELINE",
        "middle_name": "CHIARELLA",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-10",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC007096",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC013132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kamilah Reeder, PT
• Diana Reeves
• Natalie Moore Reisman, M.D.
• James Ren, D.O
• Larry J Render

• All providers in Johns Creek, GA
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.