Individual
JOHNATHAN EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18 CARMELLA CT, NEWARK, NJ 07104-3057
(347) 339-2283
Mailing address
18 CARMELLA CT, NEWARK, NJ 07104-3057
(347) 339-2283
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00560000
NJ
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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