Provider Demographics
NPI:1528428224
Name:EDWARDS COUNSELING LLC
Entity type:Organization
Organization Name:EDWARDS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARITAL AND FAMILY THERAPI
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:II
Authorized Official - Credentials:LMFT
Authorized Official - Phone:405-519-5243
Mailing Address - Street 1:423 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-2348
Mailing Address - Country:US
Mailing Address - Phone:405-519-5243
Mailing Address - Fax:
Practice Address - Street 1:423 N 19TH ST
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-2348
Practice Address - Country:US
Practice Address - Phone:405-519-5243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1128106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty