Provider Demographics
NPI:1952920597
Name:EDWARDS, LONDON E (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:LONDON
Middle Name:E
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 MANCOS ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-1611
Mailing Address - Country:US
Mailing Address - Phone:432-934-2018
Mailing Address - Fax:
Practice Address - Street 1:726 W FRANCIS ST # 1144
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1144
Practice Address - Country:US
Practice Address - Phone:970-510-5851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0017475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health