Healthcare Provider Details

I. General information

NPI: 1407033095
Provider Name (Legal Business Name): BELINDA KENT EDWARDS M.A., LPC, LAC, ADS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2008
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 NICHOLAS COVE RD
ANACOCO LA
71403-3270
US

IV. Provider business mailing address

160 NICHOLAS COVE RD
ANACOCO LA
71403-3270
US

V. Phone/Fax

Practice location:
  • Phone: 228-249-2953
  • Fax:
Mailing address:
  • Phone: 228-249-2953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1218
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4090
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number009
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: