Individual
BRIDGETTE LEORA SPANN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCAC
Contact information
Practice address
4818 INDIANAPOLIS BLVD, EAST CHICAGO, IN 46312-3433
(219) 397-5117
(219) 397-4737
Mailing address
4830 MCCOOK AVE, EAST CHICAGO, IN 46312-3552
(219) 398-9715
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000232A
IN
1041C0700X
Clinical Social Worker
Primary
34008190A
IN
Other
Enumeration date
02/16/2007
Last updated
11/02/2018
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