Provider Demographics
NPI:1740793199
Name:EDWARDS, LASHANDA L (LCSW)
Entity Type:Individual
Prefix:
First Name:LASHANDA
Middle Name:L
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LASHANDA
Other - Middle Name:L
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-0084
Mailing Address - Country:US
Mailing Address - Phone:404-594-3857
Mailing Address - Fax:404-777-9348
Practice Address - Street 1:470 COMMERCE DR STE 538
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3517
Practice Address - Country:US
Practice Address - Phone:404-594-3857
Practice Address - Fax:404-777-9348
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0056801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical