MEDICARE: MR. KENNETH J. EDWARDS M.ED

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	101YM0800X	Mental Health Counselor	PBA 001105	MA

General Provider Information

NPI Number	:	1528235579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KENNETH J. EDWARDS M.ED

Provider Business Mailing Address
First Line	:	30 LORNE ST
Second Line	:
City	:	DORCHESTER CENTER
State	:	MA
Zip	:	02124-1449
Country	:	US
Telephone Number	:	617-303-3146
Fax Number	:	617-516-0281

Provider Business Practice Location Address
First Line	:	1960 WASHINGTON ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02118-3219
Country	:	US
Telephone Number	:	617-516-0280
Fax Number	:	617-516-0280

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

Provider Enumeration Date	:	05/09/2008
Last Update Date	:	06/10/2008

Similar Medicare Providers

1801823620 — DR. JASON P BLOCK MD
Practice Location Address:

75 FRANCIS STREET , BRIGHAM INTERNAL MEDICARE ASSOCIATES
BOSTON, MA
02115

Practice Phone: 617-732-6049
Practice Fax: 617-264-5202

1164622551 — PYRAMID BUILDERS ASSOCIATES, INC
Practice Location Address:

1960 WASHINGTON ST
BOSTON, MA
02118-3219

Practice Phone: 617-516-0280
Practice Fax: 617-516-0281

1871769091 — MR. ADILSON G CARDOSO M.ED.
Practice Location Address:

1960 WASHINGTON ST
BOSTON, MA
02118-3219

Practice Phone: 617-516-0280
Practice Fax: 617-516-0281

1619137957 — MS. GLORIA MARIA AUSTRICH NCSP
Practice Location Address:

1960 WASHINGTON ST
BOSTON, MA
02118-3219

Practice Phone: 617-516-0280
Practice Fax: 617-516-0281

1164676961 — MS. LEWANDA MONIC ELLIOTT M.ED.
Practice Location Address:

1960 WASHINGTON ST
BOSTON, MA
02118-3219

Practice Phone: 617-516-0280
Practice Fax: 617-516-0281

1558503342 — VIDADE CORPORATION
Practice Location Address:

1960 WASHINGTON ST , 1960
BOSTON, MA
02118-3219

Practice Phone: 617-516-0280
Practice Fax:

Directions to “ MR. KENNETH J. EDWARDS M.ED” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.