Active NPI
Consuelo Reddick, M.D.
- Child & Adolescent Psychiatry Physician
- Roswell, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 044067
- Practice address
- 300 Colonial Center Pkwy Ste 100
Roswell, GA 30076-4892 - Phone
- (470) 670-6319
- Fax
- (888) 815-3583
- NPI assigned
- Dec 22, 2006
- Last updated
- Feb 2, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 61047950 | WA | |
| Psychiatry Physician | 2084P0800X | 89249 | MT | |
| Psychiatry Physician | 2084P0800X | G133049 | CA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD199050 | OR | |
| Psychiatry Physician | 2084P0800X | 61047950 | WA | |
| Psychiatry Physician | 2084P0800X | 044067 | GA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 044067 | GA | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 89249 | MT | |
| Psychiatry Physician | 2084P0800X | MD199050 | OR | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | G133049 | CA |
Addresses
Primary practice location
300 Colonial Center Pkwy Ste 100
Roswell, GA 30076-4892
Mailing address
400 Union Ave SE Ste 200
Olympia, WA 98501-2060
Phone (833) 351-8255
Other practice location 1
9620 NE Tanasbourne Dr Ste 300
Hillsboro, OR 97124-7844
Phone (833) 351-8255
Other practice location 2
2310 N 7th Ave Ste A
Bozeman, MT 59715-2550
Phone (833) 351-8255
Other practice location 3
400 Union Ave SE Ste 200
Olympia, WA 98501-2060
Phone (833) 351-8255
Other practice location 4
77 E Crossville Rd Ste 206
Roswell, GA 30075-3086
Phone (770) 552-4655
Other practice location 5
100 Pine St Ste 1250
San Francisco, CA 94111-5235
Phone (833) 351-8255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00024706 | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044067 | GA | MD | Psychiatry Physician |
| 89249 | MT | MD | Psychiatry Physician |
| G133049 | CA | MD | Child & Adolescent Psychiatry Physician |
| MD199050 | OR | MD | Child & Adolescent Psychiatry Physician |
| 61047950 | WA | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Psychology Center, LLC | Psychiatry | Current | Accepting new patients |
| Roswell Psychiatric Services, PC | Psychiatry | Current | Accepting new patients |
| Highland Rivers CSB | Current | Accepting new patients | |
| Highland Rivers Community Service Board | Current | Accepting new patients | |
| Highland Rivers Community Service Board | Current | Accepting new patients | |
| MCCD FL Psychiatry Services PA | Psychiatry | Current | Accepting new patients |
| Georgia Mountains Community Services | Past | Accepting new patients |
Locations
191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600
2900 Chamblee Tucker Rd
Bldg 16
Chamblee, GA 30341
Phone (770) 939-1288
1401 Applewood Dr
Ste 1
Dalton, GA 30720
Phone (706) 270-5003
1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507
300 Colonial Center Pkwy
Ofc 12
Roswell, GA 30076
Phone (833) 351-1825
77 E Crossville Rd
Ste 206
Roswell, GA 30075
Phone (770) 552-4655
10 Glenlake Pkwy
Ste 130
Sandy Springs, GA 30328
Phone (678) 230-7095
2310 N 7th Ave
Ste A
Bozeman, MT 59715
9620 NE Tanasbourne Dr
Ste 300
Hillsboro, OR 97124
Phone (833) 756-8643
400 Union Ave SE
Ste 200
Olympia, WA 98501
Phone (202) 375-4508
Interoperability endpoints
- creddick1258001@ak.providencedirect.org
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Dalton, GA
- NPI 1447256243
-
- Psychiatry Physician
- Atlanta, GA
- NPI 1063704542
-
dba Talkiatry
- Psychiatry Physician
- Jacksonville, FL
- NPI 1659003457
GA
-
- Child & Adolescent Psychiatry Physician
- Roswell, GA
- NPI 1114251188
-
- Mental Illness Community Based Residential Treatment Facility
- Rome, GA
- NPI 1538442207
-
dba Highland Rivers Whitfield Treatment Services
- Community/Behavioral Health Agency
- Dalton, GA
- NPI 1164585543
-
- Mental Health Counselor
- Cumming, GA
- NPI 1063522035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769990400000",
"number": "1437214350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 UNION AVE SE STE 200",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985012060",
"telephone_number": "833-351-8255",
"fax_number": "888-815-3583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 COLONIAL CENTER PKWY STE 100",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300764892",
"telephone_number": "470-670-6319",
"fax_number": "888-815-3583"
}
],
"practiceLocations": [
{
"address_1": "9620 NE Tanasbourne Dr Ste 300",
"address_purpose": "LOCATION",
"city": "Hillsboro",
"state": "OR",
"postal_code": "971247844",
"country_code": "US",
"telephone_number": "833-351-8255",
"fax_number": "888-815-3583",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2310 N 7th Ave Ste A",
"address_purpose": "LOCATION",
"city": "Bozeman",
"state": "MT",
"postal_code": "597152550",
"country_code": "US",
"telephone_number": "833-351-8255",
"fax_number": "888-815-3583",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "400 Union Ave SE Ste 200",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "985012060",
"country_code": "US",
"telephone_number": "833-351-8255",
"fax_number": "888-815-3583",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "77 E Crossville Rd Ste 206",
"address_purpose": "LOCATION",
"city": "Roswell",
"state": "GA",
"postal_code": "300753086",
"country_code": "US",
"telephone_number": "770-552-4655",
"fax_number": "770-552-4282",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Pine St Ste 1250",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941115235",
"country_code": "US",
"telephone_number": "833-351-8255",
"fax_number": "888-815-3583",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REDDICK",
"first_name": "CONSUELO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-22",
"last_updated": "2026-02-02",
"certification_date": "2026-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "WA",
"license": "61047950",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MT",
"license": "89249",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G133049",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "OR",
"license": "MD199050",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "61047950",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "044067",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "GA",
"license": "044067",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MT",
"license": "89249",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "MD199050",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "G133049",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00024706",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.