1497070551 NPI number — VIRGINIA ALLEN EDWARDS LMHC

Table of content: VIRGINIA ALLEN EDWARDS LMHC (NPI 1497070551)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497070551 NPI number — VIRGINIA ALLEN EDWARDS LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EDWARDS
Provider First Name:
VIRGINIA
Provider Middle Name:
ALLEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EDWARDS
Provider Other First Name:
GINGER
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1497070551
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7539 LINDEN CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FISHERS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46038-2244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-417-9891
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14741 HAZEL DELL XING
Provider Second Line Business Practice Location Address:
#400
Provider Business Practice Location Address City Name:
NOBLESVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46062-7023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-569-9090
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  39001928A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)