Provider Demographics
NPI:1184116519
Name:EDWARDS, PATRICIA NANCY (LMSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:NANCY
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 1:1581 FAWN LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9074
Mailing Address - Country:US
Mailing Address - Phone:989-701-6442
Mailing Address - Fax:
Practice Address - Street 1:1581 FAWN LAKE DR
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9074
Practice Address - Country:US
Practice Address - Phone:989-701-6442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011076981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical