Provider Demographics
NPI:1932523982
Name:EDWARDS, ALICIA (LCSWA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 US 221N HWY
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-9511
Mailing Address - Country:US
Mailing Address - Phone:828-287-5430
Mailing Address - Fax:
Practice Address - Street 1:2036 US 221N HWY
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-9511
Practice Address - Country:US
Practice Address - Phone:828-287-5430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0100071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical