MEDICARE: CYNTHIA JUNE EDWARDS LCSW, LASOP

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	1041C0700X	Clinical Social Worker	LCSW-22127	AZ

General Provider Information

NPI Number	:	1811426968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA JUNE EDWARDS LCSW, LASOP

Provider Business Mailing Address
First Line	:	11309 E SPAULDING AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85212-7024
Country	:	US
Telephone Number	:	618-889-2213
Fax Number	:

Provider Business Practice Location Address
First Line	:	11309 E SPAULDING AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85212-7024
Country	:	US
Telephone Number	:	618-889-2213
Fax Number	:

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

Provider Enumeration Date	:	06/11/2017
Last Update Date	:	04/10/2026

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