Provider Demographics
NPI:1366627325
Name:REDDING, STEFANI S
Entity Type:Individual
Prefix:MS
First Name:STEFANI
Middle Name:S
Last Name:REDDING
Suffix:
Gender:F
Credentials:
Other - Prefix:PROF
Other - First Name:STEFANI
Other - Middle Name:S
Other - Last Name:REDDING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7295 HIGHWAY 184 E
Mailing Address - Street 2:
Mailing Address - City:DONALDS
Mailing Address - State:SC
Mailing Address - Zip Code:29638-8881
Mailing Address - Country:US
Mailing Address - Phone:864-223-8331
Mailing Address - Fax:
Practice Address - Street 1:1547 PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4081
Practice Address - Country:US
Practice Address - Phone:864-223-8331
Practice Address - Fax:864-223-3706
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC421504Medicaid
SC3430Medicare PIN