Provider Demographics
NPI:1336558675
Name:EDWARDS, NATALIE MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:MARIE
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 1:1633 D ST SE
Mailing Address - Street 2:APT # 3
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2448
Mailing Address - Country:US
Mailing Address - Phone:703-943-7294
Mailing Address - Fax:
Practice Address - Street 1:3611 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE C
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3246
Practice Address - Country:US
Practice Address - Phone:703-943-7294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040086261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical