Redefine Lives, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

REDEFINE LIVES, LLC

Practice address

7113 Montague Street
Philadelphia, PA 19135

Phone

(267) 752-9421

Fax

(888) 892-2862

NPI assigned

Oct 16, 2023

Organization subpart

No

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

Authorized official

Name

Tysheira Maddox, LCSW

Title

Owner

Phone

(267) 752-9421

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tysheira Wanser, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1568066652
  NPD

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1548042450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CHESTNUT ST STE 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022700",
            "telephone_number": "267-752-9421",
            "fax_number": "888-892-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7113 MONTAGUE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19135",
            "telephone_number": "267-752-9421",
            "fax_number": "888-892-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDEFINE LIVES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-14",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "TYSHEIRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-752-9421",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vandhana Gaddum Reddy, DO
• Yuvaram Nellore Vilambi Reddy, MBBS, MPH, FASN
• Redeem American Home Care LLC
• Redeem Caring Hands
• Redeem Caring Hands LLC
• Redemption Body Wellness LLC
• Brooke Redeyoff
• Annette Redguard, MSN, CRNP
• Rediclinic LLC
• Rediclinic LLC

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.