Provider Demographics
NPI:1881055598
Name:EDWARDS, ASHAUNTI
Entity type:Individual
Prefix:
First Name:ASHAUNTI
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7928 READ BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-1324
Mailing Address - Country:US
Mailing Address - Phone:504-284-8799
Mailing Address - Fax:
Practice Address - Street 1:3222 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6252
Practice Address - Country:US
Practice Address - Phone:504-821-1788
Practice Address - Fax:504-310-8781
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA1366101YP2500X
LA7704101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator