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General NPI Number Information
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NPI Number | 1144912106
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Entity Type | Organization
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Legal Business Name | EDGE COUNSELING & CONSULTING
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Dates
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Enumeration Date | 05/25/2023
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 309 SUNFLOWER DR
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City | FAIRFAX
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State | IA
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Zip | 52228-7608
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Country | US
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Telephone | 319-350-0921
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Fax |
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Provider Business Mailing Address
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Address Line | 309 SUNFLOWER DR
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City | FAIRFAX
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State | IA
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Zip | 52228-7608
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Country | US
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Telephone | 319-350-0921
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | KYLE R SPADING
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Credential | LMHC, CRC
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Telephone | 319-350-0921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225CA2500X
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Taxonomy Name | Assistive Technology Supplier Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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