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Individual
MICHAEL EDWARDS
Active
Individual
MICHAEL EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LCPC, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
650
NH
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-LAC-LIC-13219
MT
101YM0800X
Mental Health Counselor
Primary
736
NH
101YM0800X
Mental Health Counselor
BBH-LCPC-LIC-13148
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77066380NH01
ANTHEM
—
Enumeration date
04/03/2007
Last updated
02/05/2016
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