MEDICARE: LINDSEY EDWARDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	00834	KS
2	103K00000X	Behavior Analyst	2025005775	MO
3	103K00000X	Behavior Analyst	1-23-69714	MO

General Provider Information

NPI Number	:	1184101396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY EDWARDS

Provider Business Mailing Address
First Line	:	3831 FREDERICK AVE # 212
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-3020
Country	:	US
Telephone Number	:	816-888-6226
Fax Number	:

Provider Business Practice Location Address
First Line	:	3831 FREDERICK AVE # 212
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-3020
Country	:	US
Telephone Number	:	816-888-6226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2018
Last Update Date	:	12/16/2025

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