Individual
JACQUELYN SYDNEY REDMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCAS, LCMHC, CSI
Contact information
Practice address
3607 BEATTIES FORD RD, CHARLOTTE, NC 28216-3249
(704) 394-8968
Mailing address
8420 IBM DR APT 405, CHARLOTTE, NC 28262-4587
(856) 470-6388
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
28148
NC
101YM0800X
Mental Health Counselor
17581
NC
Other
Enumeration date
06/06/2022
Last updated
10/18/2024
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