Provider Demographics
NPI:1477625507
Name:REDDICKS, MARCY M (MA, MFT, LADC)
Entity Type:Individual
Prefix:MRS
First Name:MARCY
Middle Name:M
Last Name:REDDICKS
Suffix:
Gender:F
Credentials:MA, MFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 DAMONTE RANCH PARKWAY
Mailing Address - Street 2:B355
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521
Mailing Address - Country:US
Mailing Address - Phone:775-688-1617
Mailing Address - Fax:775-688-1641
Practice Address - Street 1:421 E. PLUMB LANE
Practice Address - Street 2:#E
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509
Practice Address - Country:US
Practice Address - Phone:775-688-1617
Practice Address - Fax:775-688-1641
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0979106H00000X
NVMFT0979106H00000X
NVLADC617101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)