Provider Demographics
NPI:1407102064
Name:REDLENER PSYCHOLOGY & WELLNESS LLC
Entity type:Organization
Organization Name:REDLENER PSYCHOLOGY & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:REDLENER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-383-2920
Mailing Address - Street 1:15 OLD LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:WELLFLEET
Mailing Address - State:MA
Mailing Address - Zip Code:02667-7750
Mailing Address - Country:US
Mailing Address - Phone:617-733-8469
Mailing Address - Fax:
Practice Address - Street 1:15 OLD LONG POND RD
Practice Address - Street 2:
Practice Address - City:WELLFLEET
Practice Address - State:MA
Practice Address - Zip Code:02667-7750
Practice Address - Country:US
Practice Address - Phone:617-733-8469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-31
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9186103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty