Provider Demographics
NPI:1518054493
Name:EDWARDS, ROY N (CPC, LMHP)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:N
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:CPC, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 E. 22ND STREET
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025
Mailing Address - Country:US
Mailing Address - Phone:402-727-9995
Mailing Address - Fax:402-727-9996
Practice Address - Street 1:7902 DAVENPORT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-894-9990
Practice Address - Fax:402-727-9996
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE353101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional