Provider Demographics
NPI:1497064414
Name:EDWARDS, NATASHA LOUISE (MA LMHC)
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:LOUISE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 MADISON AVE
Mailing Address - Street 2:APT 102
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-2745
Mailing Address - Country:US
Mailing Address - Phone:336-456-2140
Mailing Address - Fax:
Practice Address - Street 1:2116 FREDERICK DOUGLASS BLVD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2332
Practice Address - Country:US
Practice Address - Phone:336-456-2140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005617101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health