Healthcare Provider Details

I. General information

NPI: 1316134869
Provider Name (Legal Business Name): CARISSIMA F EDWARDS LPC-S, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3191 ALEX KORNMAN BLVD
HARVEY LA
70058-2043
US

IV. Provider business mailing address

3191 ALEX KORNMAN BLVD
HARVEY LA
70058-2043
US

V. Phone/Fax

Practice location:
  • Phone: 504-371-0476
  • Fax:
Mailing address:
  • Phone: 504-975-4345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2789
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number853
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: