Provider Demographics
NPI:1023392305
Name:REDEEMER COUNSELING, INC.
Entity Type:Organization
Organization Name:REDEEMER COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BLACKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-405-7677
Mailing Address - Street 1:3019 WOLFE CT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-5068
Mailing Address - Country:US
Mailing Address - Phone:407-405-7677
Mailing Address - Fax:
Practice Address - Street 1:2562 ROUSE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-2902
Practice Address - Country:US
Practice Address - Phone:407-384-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9621251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health