Provider Demographics
NPI:1437627452
Name:EDWARDS, ALYSSA (TLMHC, LPC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:TLMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 SPRING ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2100
Mailing Address - Country:US
Mailing Address - Phone:608-561-7573
Mailing Address - Fax:
Practice Address - Street 1:3515 SPRING ST STE 3
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2100
Practice Address - Country:US
Practice Address - Phone:563-359-6750
Practice Address - Fax:186-649-6407
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health