Kelly Reddick, L.M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

001106 Issued in CT

Practice address

219 W Town St Ste D
Norwich, CT 06360-2130

Phone

(860) 208-1200

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Connecticut Behavioral Health Assoc, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1629158126

  Marriage & Family Therapist

  NPD (past)
• Orthopedic Physical Therapy of Southern New England LLC

  • Specialist
  • Norwich, CT
  • NPI 1043488059
  NPD (past)
• Quest Diagnostics LLC

  • Clinical Medical Laboratory
  • Norwich, CT
  • NPI 1609185883
  NPD (past)
• Select Behavioral Health, LLC

  • Psychiatry Physician
  • Norwich, CT
  • NPI 1609941731
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1316034739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 BLUE HILL RD",
            "city": "BOZRAH",
            "state": "CT",
            "postal_code": "063341001",
            "telephone_number": "860-823-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 W TOWN ST STE D",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602130",
            "telephone_number": "860-208-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Case St",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602215",
            "country_code": "US",
            "telephone_number": "860-823-1399 x111",
            "fax_number": "860-823-1170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDICK",
        "first_name": "KELLY",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Rando
• Arij Moneer Rashid, DPM
• Sarah Rasool, MD
• Mafe Duyan Rato, APRN
• Recovery Resources, LLC
• Brooklyn R Redo
• Jade Redo
• Jessica-Lou Pascubillo Reed
• Stephanie Anne Reed, LCSW
• Stanley Reels

• Marriage & Family Therapist in Norwich, CT
• Providers in Norwich, CT by specialty
• Marriage & Family Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.