Provider Demographics
NPI:1003514183
Name:EDWARDS, DEVON CHARLES (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:CHARLES
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 S QUEBEC ST APT V104
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2617
Mailing Address - Country:US
Mailing Address - Phone:518-935-3117
Mailing Address - Fax:
Practice Address - Street 1:2727 BRYANT ST STE 430
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4153
Practice Address - Country:US
Practice Address - Phone:970-573-6491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0019634101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health