Provider Demographics
NPI:1497891592
Name:EDWARDS, KAREN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5629 FM 1960 W.
Mailing Address - Street 2:SUITE 305
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4217
Mailing Address - Country:US
Mailing Address - Phone:281-880-9080
Mailing Address - Fax:
Practice Address - Street 1:5629 FM 1960 W.
Practice Address - Street 2:SUITE 305
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4217
Practice Address - Country:US
Practice Address - Phone:281-880-9080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX041081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100101821001OtherAPS HEALTHCARE
TX224960OtherANHEUSER BUSCH PIN #
TX019863OtherVALUE OPTIONS
TX145196000OtherMAGELLAN
TX231543OtherCOMPSYCH
TX101092OtherANHEUSER BUSCH PROVIDER #
TX53060Medicare UPIN
TX7935062Medicare UPIN
TX612086Medicare PIN
TX231543OtherCOMPSYCH