Provider Demographics
NPI:1780888537
Name:EDWARDS, LAURA LYNN (LPCC-S)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 ERIE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2001
Mailing Address - Country:US
Mailing Address - Phone:513-549-0160
Mailing Address - Fax:513-572-3024
Practice Address - Street 1:2619 ERIE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-2001
Practice Address - Country:US
Practice Address - Phone:513-549-0160
Practice Address - Fax:513-572-3024
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC-8163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health