Provider Demographics
NPI:1801515325
Name:EDWARDS, CHARISE LASHELL (LPC)
Entity type:Individual
Prefix:
First Name:CHARISE
Middle Name:LASHELL
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 FOX RUN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-5483
Mailing Address - Country:US
Mailing Address - Phone:908-380-4454
Mailing Address - Fax:
Practice Address - Street 1:3708 FREEMANSBURG AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-6512
Practice Address - Country:US
Practice Address - Phone:610-216-9598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional