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NPI Code Detail

MEDICARE: ELLEN STONE EDWARDS MSW,LCSW

MEDICARE:   ELLEN STONE EDWARDS  MSW,LCSW
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
11041C0700XClinical Social Worker000097NC

General Provider Information

NPI Number : 1992759898
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN STONE EDWARDS MSW,LCSW
Provider Business Mailing Address
First Line : 4096 BARRETT DR
Second Line :
City : RALEIGH
State : NC
Zip : 27609-6604
Country : US
Telephone Number : 919-787-5683
Fax Number : 919-790-7050
Provider Business Practice Location Address
First Line : 4096 BARRETT DR
Second Line :
City : RALEIGH
State : NC
Zip : 27609-6604
Country : US
Telephone Number : 919-787-5683
Fax Number : 919-790-7050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 07/08/2007

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Directions to “ ELLEN STONE EDWARDS MSW,LCSW” Practice Location

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