Provider Demographics
NPI:1497018600
Name:EDWARDS, MONICA SHONTELL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:SHONTELL
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:663 FOXCHASE LN
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-8581
Mailing Address - Country:US
Mailing Address - Phone:252-756-2394
Mailing Address - Fax:252-756-2394
Practice Address - Street 1:663 FOXCHASE LN
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8581
Practice Address - Country:US
Practice Address - Phone:252-756-2394
Practice Address - Fax:252-756-2394
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NC12532101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)