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General NPI Number Information
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NPI Number | 1427249341
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Entity Type | Individual
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Provider Name | ELIZABETH EDMUNDS LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 903 W MARTIN ST
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City | SAN ANTONIO
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State | TX
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Zip | 78207-0903
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Country | US
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Telephone | 210-358-3108
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Fax | 210-358-3067
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Provider Business Mailing Address
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Address Line | PO BOX 87
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City | SAN ANTONIO
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State | TX
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Zip | 78291-0087
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Country | US
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Telephone | 210-358-9500
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Fax | 210-358-9183
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 62296
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License Number State | TX
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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 | CW022190
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License Number State | PA
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