Provider Demographics
NPI:1962298042
Name:EDWARDS, JOSEPH (LSW, LCADC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:
Credentials:LSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:983 SHERBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-2221
Mailing Address - Country:US
Mailing Address - Phone:856-571-4191
Mailing Address - Fax:
Practice Address - Street 1:983 SHERBROOK CIR
Practice Address - Street 2:
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-2221
Practice Address - Country:US
Practice Address - Phone:856-571-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00400000101YA0400X
NJ44SL07256700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health