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General NPI Number Information
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NPI Number | 1891655767
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Entity Type | Individual
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Provider Name | LISA EDWARDS PSYD
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Gender | Female
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 100 S JUNIPER ST FL 3
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City | PHILADELPHIA
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State | PA
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Zip | 19107-1316
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Country | US
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Telephone | 267-217-3359
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Fax |
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Provider Business Mailing Address
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Address Line | 1 UNIVERSITY PL
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City | CHESTER
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State | PA
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Zip | 19013-5792
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Country | US
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Telephone |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS019939
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | B1-0011414
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License Number State | DE
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