Provider Demographics
NPI:1821184805
Name:REDDEN, JOHN H (LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:REDDEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 LAURIE CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3046
Mailing Address - Country:US
Mailing Address - Phone:731-697-7733
Mailing Address - Fax:
Practice Address - Street 1:367B N PARKWAY STE 1
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2899
Practice Address - Country:US
Practice Address - Phone:731-668-2277
Practice Address - Fax:731-660-0510
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC 1597101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional