Provider Demographics
NPI:1972899813
Name:EDWARDS, MARTHA ANN (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:ANN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 N ROLLING RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1975
Mailing Address - Country:US
Mailing Address - Phone:410-952-2651
Mailing Address - Fax:410-597-8787
Practice Address - Street 1:3113 RICHWOOD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2819
Practice Address - Country:US
Practice Address - Phone:410-952-2651
Practice Address - Fax:410-597-8787
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD145801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical