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Organization
SCOTT A EDWARDS PHD, PC
Active
Organization
SCOTT A EDWARDS PHD, PC
Active
Other names
Lighthouse Family Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT A EDWARDS PHD HSPP (PRESIDENT)
(765) 854-6010
Entity
Organization
Contact information
Practice address
1216 W JEFFERSON ST, KOKOMO, IN 46901-4341
(765) 854-6010
(765) 854-6011
Mailing address
PO BOX 6181, KOKOMO, IN 46904-6181
(765) 854-6010
(765) 854-6011
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000504024
ANTHEM
IN
05
—
200365360
—
IN
01
—
713933000
MAGELLAN
—
Enumeration date
08/10/2006
Last updated
12/08/2010
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