Provider Demographics
NPI:1508281320
Name:EDWARDS, MALAIKA MICHELLE (LPCA)
Entity Type:Individual
Prefix:MS
First Name:MALAIKA
Middle Name:MICHELLE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 ARBOR WAY
Mailing Address - Street 2:APT 2B
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3339
Mailing Address - Country:US
Mailing Address - Phone:978-853-5042
Mailing Address - Fax:
Practice Address - Street 1:3712 BENSON DR
Practice Address - Street 2:STE 202
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7328
Practice Address - Country:US
Practice Address - Phone:888-557-4080
Practice Address - Fax:919-249-2150
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10615101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional