Provider Demographics
NPI:1679060867
Name:EDWARDS, CHRISTINE (CADC-I)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 S MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:YERINGTON
Mailing Address - State:NV
Mailing Address - Zip Code:89447-2474
Mailing Address - Country:US
Mailing Address - Phone:775-463-6597
Mailing Address - Fax:775-463-6598
Practice Address - Street 1:415 HIGHWAY 95A
Practice Address - Street 2:SUITE H802
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-2474
Practice Address - Country:US
Practice Address - Phone:775-575-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV02617-1101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)