Provider Demographics
NPI:1558357772
Name:REDWOOD, SONDRA M (LPCC LADAC)
Entity Type:Individual
Prefix:MS
First Name:SONDRA
Middle Name:M
Last Name:REDWOOD
Suffix:
Gender:F
Credentials:LPCC LADAC
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 4339
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106
Mailing Address - Country:US
Mailing Address - Phone:505-261-0952
Mailing Address - Fax:
Practice Address - Street 1:301 GRACELAND SE
Practice Address - Street 2:SUITE A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108
Practice Address - Country:US
Practice Address - Phone:505-261-0952
Practice Address - Fax:505-261-0952
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3591101YA0400X
NM0851101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health