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General NPI Number Information
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NPI Number | 1952859480
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Entity Type | Individual
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Provider Name | ARETHA HARGROVE EDWARDS ED.D, LPC-S, ACS,ETC
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Gender | Female
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 209 MAIN ST
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City | GREENVILLE
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State | MS
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Zip | 38701
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Country | US
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Telephone | 662-347-7229
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Fax | 662-332-7225
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Provider Business Mailing Address
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Address Line | PO BOX 4851
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City | GREENVILLE
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State | MS
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Zip | 38704-4851
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Country | US
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Telephone | 662-931-0287
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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 | 1221
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License Number State | MS
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