Provider Demographics
NPI:1629324611
Name:EDWARDS, BRIE ALEXANDRIA (MA, LMFT)
Entity Type:Individual
Prefix:MISS
First Name:BRIE
Middle Name:ALEXANDRIA
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 LAVELL CT
Mailing Address - Street 2:
Mailing Address - City:MARINA
Mailing Address - State:CA
Mailing Address - Zip Code:93933-3410
Mailing Address - Country:US
Mailing Address - Phone:714-655-3926
Mailing Address - Fax:
Practice Address - Street 1:957 BLANCO CIR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4447
Practice Address - Country:US
Practice Address - Phone:831-784-2152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108747106H00000X
CA92146101YM0800X, 106H00000X
171M00000X, 225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner