Healthcare Provider Details

I. General information

NPI: 1811903941
Provider Name (Legal Business Name): JAMES STEPHEN EDWARDS MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEVE EDWARDS MSW, LCSW

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 W. SYCAMORE STREET
KOKOMO IN
46904-9010
US

IV. Provider business mailing address

11708 CRESTVIEW BLVD
KOKOMO IN
46901-9700
US

V. Phone/Fax

Practice location:
  • Phone: 765-456-5900
  • Fax: 765-456-5387
Mailing address:
  • Phone: 765-434-6602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34002244A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number80000015A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: