Provider Demographics
NPI:1659883155
Name:REDDING, MARCELENE KUBACKI (EDS,NCC, LMHC)
Entity Type:Individual
Prefix:
First Name:MARCELENE
Middle Name:KUBACKI
Last Name:REDDING
Suffix:
Gender:F
Credentials:EDS,NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 YOUNGS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-3841
Mailing Address - Country:US
Mailing Address - Phone:901-486-0161
Mailing Address - Fax:
Practice Address - Street 1:441 EAST AVE STE 3
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1932
Practice Address - Country:US
Practice Address - Phone:585-461-0110
Practice Address - Fax:585-461-9658
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health