Healthcare Provider Details

I. General information

NPI: 1356651186
Provider Name (Legal Business Name): ROBERT JAMES EDMONDSON JR. LCSWA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 FAIRVIEW RD OFC 4
ASHEVILLE NC
28803-1171
US

IV. Provider business mailing address

37 CRESTVIEW ST
ASHEVILLE NC
28803-1311
US

V. Phone/Fax

Practice location:
  • Phone: 828-367-7719
  • Fax: 828-820-5503
Mailing address:
  • Phone: 828-367-7719
  • Fax: 828-820-5503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023449
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: