Healthcare Provider Details

I. General information

NPI: 1821499518
Provider Name (Legal Business Name): CASSAUNDRA GAMBLE-EDWARDS MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2014
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 WOODRUFF RD STE 450
GREENVILLE SC
29607-3443
US

IV. Provider business mailing address

8595 PELHAM RD STE 400
GREENVILLE SC
29615-5763
US

V. Phone/Fax

Practice location:
  • Phone: 864-400-5130
  • Fax:
Mailing address:
  • Phone: 864-553-1076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7810
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: