Provider Demographics
NPI:1891424065
Name:REDMAYNE, KELSEY (MS)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:REDMAYNE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CISCO RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-1107
Mailing Address - Country:US
Mailing Address - Phone:618-580-0947
Mailing Address - Fax:
Practice Address - Street 1:501 DARBY CREEK RD STE 41
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1671
Practice Address - Country:US
Practice Address - Phone:859-227-2337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY270056103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist