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General NPI Number Information
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NPI Number | 1447324520
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Entity Type | Individual
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Provider Name | EDWIN DONALD POAGE LPC LCDC
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3000 N GARFIELD SUITE 230 HERITAGE COUNSELING
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City | MIDLAND
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State | TX
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Zip | 79705
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Country | US
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Telephone | 432-685-3787
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Fax | 432-685-9998
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Provider Business Mailing Address
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Address Line | 3000 N GARFIELD SUITE 230 HERITAGE COUNSELING
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City | MIDLAND
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State | TX
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Zip | 79705
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Country | US
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Telephone | 432-685-3787
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Fax | 432-685-9998
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 3483
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LPC14328
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License Number State | TX
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