Provider Demographics
NPI:1669651220
Name:EDWARDS, CARMENCITA C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CARMENCITA
Middle Name:C
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 1:2820 ATHANIA PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5981
Mailing Address - Country:US
Mailing Address - Phone:504-251-0638
Mailing Address - Fax:504-302-9448
Practice Address - Street 1:2820 ATHANIA PKWY STE 2
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5981
Practice Address - Country:US
Practice Address - Phone:504-251-0638
Practice Address - Fax:504-302-9448
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2346101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5T794Medicare PIN