MEDICARE: MRS. ALICE MARIE EDWARDS LMFT

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	106H00000X	Marriage & Family Therapist	MFT001438	GA

General Provider Information

NPI Number	:	1629438338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICE MARIE EDWARDS LMFT

Provider Business Mailing Address
First Line	:	6345 CALAMAR DR
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-7628
Country	:	US
Telephone Number	:	404-270-0683
Fax Number	:

Provider Business Practice Location Address
First Line	:	2854 JOHNSON FERRY RD STE 200
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-5699
Country	:	US
Telephone Number	:	404-270-0683
Fax Number	:

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

Provider Enumeration Date	:	02/24/2016
Last Update Date	:	12/14/2025

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