Individual
MS. ELIZABETH THEOLA EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1400 NW 14 CT., MASTER MIND CARE, INC. ATTN: ELIZABETH EDWARDS, FT. LAUDERDALE, FL 33311
(754) 333-1196
(954) 785-6120
Mailing address
4575 NW 91 AVE, SUNRISE, FL 33351
(754) 333-1196
(305) 757-4465
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SW16637
FL
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
SW16637
FL
1041S0200X
School Social Worker
SW16637
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH684
MEDICARE PROVIDER
FL
Enumeration date
05/22/2007
Last updated
07/20/2020
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