Provider Demographics
NPI:1386092237
Name:REDELMAN, BARRETT (LCSW)
Entity type:Individual
Prefix:
First Name:BARRETT
Middle Name:
Last Name:REDELMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22701 SUNDANCE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3348
Mailing Address - Country:US
Mailing Address - Phone:317-937-8348
Mailing Address - Fax:
Practice Address - Street 1:12105 ALLEGHENY ST
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352
Practice Address - Country:US
Practice Address - Phone:323-217-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW70424104100000X
IN34009090A1041C0700X
CA929841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker