Provider Demographics
NPI:1851171862
Name:EDWARDS, JEANNE MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BELVEDERE LN
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-4705
Mailing Address - Country:US
Mailing Address - Phone:845-532-2079
Mailing Address - Fax:
Practice Address - Street 1:307 WALL ST STE 3
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-8002
Practice Address - Country:US
Practice Address - Phone:845-532-2079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116549-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical