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General NPI Number Information
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NPI Number | 1912534199
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Entity Type | Individual
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Provider Name | BARBARA MICHELLE EDWARDS LCSW, CADAC III MATS
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Gender | Female
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 777 S MAIN ST STE 100
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City | CLINTON
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State | IN
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Zip | 47842-2493
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Country | US
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Telephone | 765-828-1003
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Fax |
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Provider Business Mailing Address
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Address Line | 15671 N 1190TH ST
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City | MARSHALL
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State | IL
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Zip | 62441-4152
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Country | US
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Telephone | 217-264-3260
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 330009277A
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License Number State | IN
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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 | 34010188A
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License Number State | IN
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