Provider Demographics
NPI:1982046876
Name:REDMAN, TRACY (LHMC)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:
Last Name:REDMAN
Suffix:
Gender:F
Credentials:LHMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12469 JODA LN E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-2109
Mailing Address - Country:US
Mailing Address - Phone:904-472-6179
Mailing Address - Fax:833-974-0773
Practice Address - Street 1:3781 SAN JOSE PL
Practice Address - Street 2:WISECOUNSEL STE 29
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257
Practice Address - Country:US
Practice Address - Phone:904-472-6179
Practice Address - Fax:833-974-0773
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16290101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health