Provider Demographics
NPI:1821292855
Name:EDWARDS, BOBBIE LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BOBBIE
Middle Name:LYNN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:908-479-4570
Practice Address - Street 1:134 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822
Practice Address - Country:US
Practice Address - Phone:908-892-8978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional