Healthcare Provider Details

I. General information

NPI: 1831613991
Provider Name (Legal Business Name): JOAN LAWRENCE EDD, LPCS, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28612 WINDBREAK TER
SANTA CLARITA CA
91350-5893
US

IV. Provider business mailing address

28612 WINDBREAK TER
SANTA CLARITA CA
91350-5893
US

V. Phone/Fax

Practice location:
  • Phone: 336-687-5402
  • Fax:
Mailing address:
  • Phone: 336-687-5402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS7510
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number85472
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number21153
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: