Provider Demographics
NPI:1841174125
Name:KODAK REDY CONSULTANT SERVICES, LLC
Entity type:Organization
Organization Name:KODAK REDY CONSULTANT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEE
Authorized Official - Middle Name:G
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:864-425-6829
Mailing Address - Street 1:109 MONTCLAIR DR APT A
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-3408
Mailing Address - Country:US
Mailing Address - Phone:864-425-6829
Mailing Address - Fax:
Practice Address - Street 1:109 MONTCLAIR DR APT A
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-3408
Practice Address - Country:US
Practice Address - Phone:864-425-6829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)