Provider Demographics
NPI:1942840244
Name:EDWARDS, JOSHUA MICHAEL (PHD, LPC, LMHC, NCC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MICHAEL
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:PHD, LPC, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 MOODY RD
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-3221
Mailing Address - Country:US
Mailing Address - Phone:502-554-4409
Mailing Address - Fax:
Practice Address - Street 1:242 MOODY RD
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3221
Practice Address - Country:US
Practice Address - Phone:502-554-4409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11955101YM0800X
TX73872103TC1900X
CT4570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling