Provider Demographics
NPI:1750716403
Name:EDWARDS, RAASHIDA M (DSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:RAASHIDA
Middle Name:M
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 BROADWAY
Mailing Address - Street 2:#123
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002
Mailing Address - Country:US
Mailing Address - Phone:917-504-9139
Mailing Address - Fax:
Practice Address - Street 1:462 AVENUE C
Practice Address - Street 2:#101
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002
Practice Address - Country:US
Practice Address - Phone:917-504-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0920341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical