Provider Demographics
NPI:1912270810
Name:EDWARDS, DELORIS A (LCSW)
Entity Type:Individual
Prefix:
First Name:DELORIS
Middle Name:A
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DELORIS
Other - Middle Name:A
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWW
Mailing Address - Street 1:445 WINN WAY
Mailing Address - Street 2:DEKALB COMMUNITY SERVICE BOARD
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1707
Mailing Address - Country:US
Mailing Address - Phone:404-508-6448
Mailing Address - Fax:404-508-7891
Practice Address - Street 1:445 WINN WAY
Practice Address - Street 2:DEKALB COMMUNITY SERVICE BOARD
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1707
Practice Address - Country:US
Practice Address - Phone:404-508-6448
Practice Address - Fax:404-508-7891
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0045051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical