Provider Demographics
NPI:1821825811
Name:REDMOND, MATT (BCPC)
Entity type:Individual
Prefix:MR
First Name:MATT
Middle Name:
Last Name:REDMOND
Suffix:
Gender:M
Credentials:BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 PAIGE DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-1650
Mailing Address - Country:US
Mailing Address - Phone:205-470-4774
Mailing Address - Fax:
Practice Address - Street 1:2269 CHAPEL RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-1403
Practice Address - Country:US
Practice Address - Phone:205-470-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral