Provider Demographics
NPI:1225709520
Name:JAMES, EDWARD LAWRENCE III (MDW, LMSW)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:LAWRENCE
Last Name:JAMES
Suffix:III
Gender:M
Credentials:MDW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8220 E KEIM DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-5845
Mailing Address - Country:US
Mailing Address - Phone:602-684-8198
Mailing Address - Fax:
Practice Address - Street 1:2102 W BETHANY HOME RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1935
Practice Address - Country:US
Practice Address - Phone:602-774-4745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-26
Last Update Date:2021-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ129151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical