Deanna Redman, BS

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Practice address

562 Wyoming Ave
Kingston, PA 18704-3721

Phone

(570) 552-3700

Fax

(570) 552-3705

NPI assigned

Jul 11, 2007

Sex

Female

Sole proprietor

Yes

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

Bachelor of Science

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1316146368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 NORTH ST",
            "city": "COURTDALE",
            "state": "PA",
            "postal_code": "187041713",
            "telephone_number": "570-954-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043721",
            "telephone_number": "570-552-3700",
            "fax_number": "570-552-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMAN",
        "first_name": "DEANNA",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Kingston, PA
• Providers in Kingston, PA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.