Provider Demographics
NPI:1336762285
Name:EDWARDS, DAVID (LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1176 E WARNER RD STE 203
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3069
Mailing Address - Country:US
Mailing Address - Phone:480-567-5176
Mailing Address - Fax:
Practice Address - Street 1:1176 E WARNER RD STE 203
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3069
Practice Address - Country:US
Practice Address - Phone:480-466-0756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-22454101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor