Provider Demographics
NPI:1821764473
Name:EDWARDS, JANELL LYNN (NCC, LCMHCA)
Entity Type:Individual
Prefix:
First Name:JANELL
Middle Name:LYNN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:NCC, LCMHCA
Other - Prefix:
Other - First Name:JAE
Other - Middle Name:
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCC, LCMHCA
Mailing Address - Street 1:1007 MORGANTON BLVD SW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5605
Mailing Address - Country:US
Mailing Address - Phone:828-222-0032
Mailing Address - Fax:
Practice Address - Street 1:1007 MORGANTON BLVD SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5605
Practice Address - Country:US
Practice Address - Phone:828-222-0032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16818101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health