Provider Demographics
NPI:1104080720
Name:TOWNSEND, EDWINA JOHNSON (MED, LPC-S)
Entity type:Individual
Prefix:MS
First Name:EDWINA
Middle Name:JOHNSON
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:MED, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9555 LEBANON RD
Mailing Address - Street 2:SUITE 903
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-6095
Mailing Address - Country:US
Mailing Address - Phone:972-679-5775
Mailing Address - Fax:214-407-8482
Practice Address - Street 1:9555 LEBANON RD
Practice Address - Street 2:SUITE 903
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6095
Practice Address - Country:US
Practice Address - Phone:972-679-5775
Practice Address - Fax:214-407-8482
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-13
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13531101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional