Individual
JENNIFER L EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1090 CRANSTON ST, CRANSTON, RI 02920-7323
(401) 467-9610
Mailing address
1090 CRANSTON ST, CRANSTON, RI 02920-7323
(401) 467-9610
(401) 223-0121
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02865
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146467
ANTHEM BCBS
VA
Enumeration date
11/09/2006
Last updated
12/31/2020
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