Provider Demographics
NPI:1144309071
Name:REDINGTON, TRISA REA (MS LPC)
Entity type:Individual
Prefix:MRS
First Name:TRISA
Middle Name:REA
Last Name:REDINGTON
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 AUDRAIN COUNTY RD. 233
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65240-5217
Mailing Address - Country:US
Mailing Address - Phone:660-651-2320
Mailing Address - Fax:573-682-2530
Practice Address - Street 1:283 AUDRAIN COUNTY RD. 233
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:MO
Practice Address - Zip Code:65240-5217
Practice Address - Country:US
Practice Address - Phone:660-651-2320
Practice Address - Fax:573-682-2530
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004008733101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional