Provider Demographics
NPI:1104698067
Name:SENTINEL MENTAL WELLNESS CENTER PLLC
Entity type:Organization
Organization Name:SENTINEL MENTAL WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:REDDING
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:919-594-1235
Mailing Address - Street 1:1300 BENSON RD STE 106
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4687
Mailing Address - Country:US
Mailing Address - Phone:919-594-1235
Mailing Address - Fax:
Practice Address - Street 1:1300 BENSON RD STE 106
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-4687
Practice Address - Country:US
Practice Address - Phone:910-922-3242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty