Provider Demographics
NPI:1760840490
Name:INTERACT PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:INTERACT PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:REDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:205-523-8219
Mailing Address - Street 1:15 OFFICE PARK CIR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2524
Mailing Address - Country:US
Mailing Address - Phone:205-523-8219
Mailing Address - Fax:205-523-8219
Practice Address - Street 1:15 OFFICE PARK CIR
Practice Address - Street 2:SUITE 140
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2524
Practice Address - Country:US
Practice Address - Phone:205-523-8219
Practice Address - Fax:205-523-8219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1147103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty