Kelly E Redwine Lpc LLC

NPI #1093304297 in Braselton, Georgia

Provider Information

NPI Number: 1093304297
Entity Type: Organization
Organization Name: Kelly E Redwine Lpc LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Jan 12, 2021
Last Updated: Oct 28, 2021

Practice Location

Address: 300 BROADWAY AVE
City: Braselton
State: Georgia
ZIP Code: 30517
Phone: (770) 695-7501

Authorized Official

Name: KELLY REDWINE, LPC
Title: OWNER
Phone: (770) 695-7501

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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