Provider Demographics
NPI:1407669823
Name:CHUCK EDWARDS COUNSELING, LLC
Entity type:Organization
Organization Name:CHUCK EDWARDS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-T
Authorized Official - Phone:316-204-3630
Mailing Address - Street 1:316 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:KS
Mailing Address - Zip Code:67144-8833
Mailing Address - Country:US
Mailing Address - Phone:316-204-3630
Mailing Address - Fax:
Practice Address - Street 1:316 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:KS
Practice Address - Zip Code:67144-8833
Practice Address - Country:US
Practice Address - Phone:316-204-3630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty