Provider Demographics
NPI:1508462615
Name:REDEMPTION PSYCHOTHERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:REDEMPTION PSYCHOTHERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUGUTT
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:701-320-8623
Mailing Address - Street 1:41989 MORRISON LINE RD
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:MN
Mailing Address - Zip Code:56443-5034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:41989 MORRISON LINE RD
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:MN
Practice Address - Zip Code:56443-5034
Practice Address - Country:US
Practice Address - Phone:701-320-8623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health