MEDICARE: SYKIA EDWARDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	AC2234	MA
2	104100000X	Social Worker	28070	MD

General Provider Information

NPI Number	:	1093103756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYKIA EDWARDS

Provider Business Mailing Address
First Line	:	3211 CORPORATE CT UNIT A
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2247
Country	:	US
Telephone Number	:	410-297-0932
Fax Number	:

Provider Business Practice Location Address
First Line	:	3211 CORPORATE CT # 6A
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2247
Country	:	US
Telephone Number	:	410-297-0932
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2015
Last Update Date	:	05/20/2024

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Directions to “ SYKIA EDWARDS ” Practice Location

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