Provider Demographics
NPI:1003356908
Name:EDWARDS, LINDSAY MEEKS
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:MEEKS
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 N 11TH ST
Mailing Address - Street 2:STEPHEN & SANDRA SHELLER 11TH STREET FAMILY HEALTH SERV
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-1957
Mailing Address - Country:US
Mailing Address - Phone:215-769-1115
Mailing Address - Fax:215-769-1117
Practice Address - Street 1:850 N 11TH ST
Practice Address - Street 2:STEPHEN & SANDRA SHELLER 11TH STREET FAMILY HEALTH SERV
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-1957
Practice Address - Country:US
Practice Address - Phone:215-769-1115
Practice Address - Fax:215-769-1117
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional