Crystal Deanna Redd, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4173 Issued in AL

Practice address

2611 Lily Way
Northport, AL 35473-1775

Phone

(630) 768-9645

Fax

(205) 339-7246

NPI assigned

Apr 20, 2012

Last updated

Nov 26, 2019By the provider in NPPES

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

State licenses

Interoperability endpoints

• Direct secure messaging: crystal.redd.1@22469.direct.athenahealth.com

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1578820114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 LILY WAY",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354731775",
            "telephone_number": "630-768-9645",
            "fax_number": "205-339-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 LILY WAY",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354731775",
            "telephone_number": "630-768-9645",
            "fax_number": "205-339-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDD",
        "first_name": "CRYSTAL",
        "middle_name": "DEANNA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "4173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Northport, AL
• Providers in Northport, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.