Provider Demographics
NPI:1205277787
Name:EDWARDS, INGELA GULLVI (LPC)
Entity type:Individual
Prefix:
First Name:INGELA
Middle Name:GULLVI
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6751 VIRGINIA PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5515
Mailing Address - Country:US
Mailing Address - Phone:214-551-0422
Mailing Address - Fax:
Practice Address - Street 1:6751 VIRGINIA PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5515
Practice Address - Country:US
Practice Address - Phone:214-551-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67044101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health