Provider Demographics
NPI:1134572985
Name:EDWARDS, RANDI (LCSW)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7854 HAMPTON FOREST LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-1974
Mailing Address - Country:US
Mailing Address - Phone:804-286-2456
Mailing Address - Fax:
Practice Address - Street 1:8005 CREIGHTON PKWY STE C
Practice Address - Street 2:STE 234
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-4594
Practice Address - Country:US
Practice Address - Phone:804-839-7873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040087561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical