Provider Demographics
NPI:1447072558
Name:REDMOND, JESSICA JEAN (DMFT LPC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:JEAN
Last Name:REDMOND
Suffix:
Gender:F
Credentials:DMFT LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 TULSK RD
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19311-1381
Mailing Address - Country:US
Mailing Address - Phone:267-530-1947
Mailing Address - Fax:
Practice Address - Street 1:301 RUTHAR DR STE C
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-8031
Practice Address - Country:US
Practice Address - Phone:484-899-0311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0011699101YP2500X
PAPC016670101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional