Provider Demographics
NPI:1104959204
Name:EDWARDS, DANIELLE FELDER (LPC)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:FELDER
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6419 PENCADE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3745
Mailing Address - Country:US
Mailing Address - Phone:704-569-1932
Mailing Address - Fax:
Practice Address - Street 1:6419 PENCADE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3745
Practice Address - Country:US
Practice Address - Phone:704-569-1932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102078Medicaid
NC6005151Medicaid