Provider Demographics
NPI:1073691911
Name:REDMAN, KARLA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:
Last Name:REDMAN
Suffix:
Gender:F
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:PO BOX 2746
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-6509
Mailing Address - Country:US
Mailing Address - Phone:678-447-5063
Mailing Address - Fax:
Practice Address - Street 1:2450 ATLANTA HWY STE 1301
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-1277
Practice Address - Country:US
Practice Address - Phone:786-447-5063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0026821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA729847301AMedicaid
GA729847301AMedicaid