Provider Demographics
NPI:1528480068
Name:EDWARDS, LATOYA CT (LPC)
Entity type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:CT
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 1:1717 GERVAIS ST
Mailing Address - Street 2:STE. 204
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3415
Mailing Address - Country:US
Mailing Address - Phone:803-740-0966
Mailing Address - Fax:803-741-5801
Practice Address - Street 1:1717 GERVAIS ST
Practice Address - Street 2:STE. 204
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3415
Practice Address - Country:US
Practice Address - Phone:803-740-0966
Practice Address - Fax:803-741-5801
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-17
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5629101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional