Provider Demographics
NPI:1245642388
Name:EDWARDS, MYREI CHRYSTI (LCSW)
Entity type:Individual
Prefix:
First Name:MYREI
Middle Name:CHRYSTI
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 1:14922 EL TESORO DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-2520
Mailing Address - Country:US
Mailing Address - Phone:832-244-7428
Mailing Address - Fax:
Practice Address - Street 1:4500 MONTROSE BLVD STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5842
Practice Address - Country:US
Practice Address - Phone:832-244-7428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical