Provider Demographics
NPI:1841614443
Name:EDWARDS, JAMI LEE (LISW)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:LEE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 ROANOKE AVE
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1243
Mailing Address - Country:US
Mailing Address - Phone:330-329-8565
Mailing Address - Fax:
Practice Address - Street 1:749 ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1243
Practice Address - Country:US
Practice Address - Phone:330-329-8565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.13020891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical