Provider Demographics
NPI:1902886823
Name:EDWARDS, CYNTHIA DEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:DEE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4776
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-4776
Mailing Address - Country:US
Mailing Address - Phone:336-431-1888
Mailing Address - Fax:336-431-2217
Practice Address - Street 1:10547 N MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:ARCHDALE
Practice Address - State:NC
Practice Address - Zip Code:27263-2883
Practice Address - Country:US
Practice Address - Phone:336-431-1888
Practice Address - Fax:336-431-2217
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0010121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC30091OtherBLUE CROSS/BLUE SHIELD
NC6002865Medicaid
NC6002865Medicaid