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General NPI Number Information
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NPI Number | 1306383245
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Entity Type | Individual
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Provider Name | KENNETH F EDWARDS LPCC, LCPC
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Gender | Male
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 01/19/2018
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Provider Practice Location Address
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Address Line | 155 MONTGOMERY ST STE 507
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-4110
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Country | US
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Telephone | 415-494-7686
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Fax |
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Provider Business Mailing Address
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Address Line | 227 DOUGLASS ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-2424
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Country | US
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Telephone | 214-662-1040
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180010430
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License Number State | IL
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