Provider Demographics
NPI:1538276639
Name:REDDEN, GINGER (LCSW)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:REDDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USAMEDDAC WUERZBURG ATTN:CREDENTIALS OFFICE
Mailing Address - Street 2:UNIT 26610
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09244
Mailing Address - Country:DE
Mailing Address - Phone:01149931-804-3616
Mailing Address - Fax:01149931-804-3241
Practice Address - Street 1:USAMEDDAC WUERZBURG
Practice Address - Street 2:USAHC VILSECK
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09112
Practice Address - Country:DE
Practice Address - Phone:01149966-283-3324
Practice Address - Fax:01149966-283-2061
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN