Provider Demographics
NPI:1093220881
Name:EDMOND, LAMONT (LCSWA)
Entity Type:Individual
Prefix:MR
First Name:LAMONT
Middle Name:
Last Name:EDMOND
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12316 MCCOLL RD APT 204
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-7982
Mailing Address - Country:US
Mailing Address - Phone:347-229-4163
Mailing Address - Fax:
Practice Address - Street 1:12316 MCCOLL RD APT 204
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-7982
Practice Address - Country:US
Practice Address - Phone:347-229-4163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0119431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical