Provider Demographics
NPI:1801393699
Name:EDMOND, SANTACIA (LSW)
Entity type:Individual
Prefix:MS
First Name:SANTACIA
Middle Name:
Last Name:EDMOND
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18661 RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-1643
Mailing Address - Country:US
Mailing Address - Phone:440-661-5241
Mailing Address - Fax:
Practice Address - Street 1:27600 CHAGRIN BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:OH
Practice Address - Zip Code:44122-4421
Practice Address - Country:US
Practice Address - Phone:216-417-8813
Practice Address - Fax:216-916-4783
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker