Provider Demographics
NPI:1598875247
Name:REDDICK-UMOJA, ISIS (LPC)
Entity Type:Individual
Prefix:MS
First Name:ISIS
Middle Name:
Last Name:REDDICK-UMOJA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 NEWPORT DR
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-7169
Mailing Address - Country:US
Mailing Address - Phone:704-733-7475
Mailing Address - Fax:704-662-0866
Practice Address - Street 1:122 GATEWAY BLVD STE C
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5544
Practice Address - Country:US
Practice Address - Phone:704-733-7475
Practice Address - Fax:704-662-0866
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5341101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health