Provider Demographics
NPI:1093272197
Name:ENGLISH, EDNA DOREEN (LPC)
Entity Type:Individual
Prefix:
First Name:EDNA
Middle Name:DOREEN
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:EDNA
Other - Middle Name:DOREEN
Other - Last Name:KANDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 YAHWEH DR
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-0165
Mailing Address - Country:US
Mailing Address - Phone:828-620-5505
Mailing Address - Fax:
Practice Address - Street 1:115 BLACK MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-3402
Practice Address - Country:US
Practice Address - Phone:828-620-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12544101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional