Healthcare Provider Details

I. General information

NPI: 1629438338
Provider Name (Legal Business Name): ALICE MARIE EDWARDS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2854 JOHNSON FERRY RD STE 200
MARIETTA GA
30062-5699
US

IV. Provider business mailing address

6345 CALAMAR DR
CUMMING GA
30040-7628
US

V. Phone/Fax

Practice location:
  • Phone: 404-270-0683
  • Fax:
Mailing address:
  • Phone: 404-270-0683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT001438
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: