Provider Demographics
NPI:1881307163
Name:EDWARDS, LAKEERAH
Entity type:Individual
Prefix:
First Name:LAKEERAH
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 1:5303 BRISTOL STATION CT
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-3167
Mailing Address - Country:US
Mailing Address - Phone:862-246-3954
Mailing Address - Fax:
Practice Address - Street 1:5303 BRISTOL STATION CT
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-3167
Practice Address - Country:US
Practice Address - Phone:862-246-3954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker