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General NPI Number Information
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NPI Number | 1114738432
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Entity Type | Individual
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Provider Name | KELLI HANNA EDWARDS LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 910 COOK RD
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City | ORANGEBURG
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State | SC
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Zip | 29118-2124
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Country | US
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Telephone | 803-536-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 3041 HOLMANSCROSSROAD
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City | GOODWATER
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State | AL
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Zip | 35072-5073
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Country | US
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Telephone | 334-301-8653
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6088G
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0903003847
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 17370
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License Number State | SC
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