Provider Demographics
NPI:1013559988
Name:EDWARDS, ALICE (LPPT, LCDC, MRT,MS)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LPPT, LCDC, MRT,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WEST LOOP S STE 900
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3522
Mailing Address - Country:US
Mailing Address - Phone:979-248-5649
Mailing Address - Fax:
Practice Address - Street 1:2100 WEST LOOP S STE 800
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3522
Practice Address - Country:US
Practice Address - Phone:979-248-5649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-12
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 103TB0200X, 103TC1900X, 101Y00000X, 101YM0800X, 103TF0000X, 106H00000X, 133N00000X, 171000000X, 171M00000X, 172V00000X, 174H00000X, 374K00000X
MSAE719444D101YP1600X
TX10292101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No171000000XOther Service ProvidersMilitary Health Care Provider
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner