Provider Demographics
NPI:1073245056
Name:REDMAN, SERENA
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:REDMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 ROBERT C BYRD INDUSTRIAL PARK
Mailing Address - Street 2:
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26836-8508
Mailing Address - Country:US
Mailing Address - Phone:304-538-2302
Mailing Address - Fax:304-538-7111
Practice Address - Street 1:79 ROBERT C BYRD INDUSTRIAL PARK
Practice Address - Street 2:
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836-8508
Practice Address - Country:US
Practice Address - Phone:304-538-2302
Practice Address - Fax:304-538-7111
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No172V00000XOther Service ProvidersCommunity Health Worker