Organization
CAROL B EDWARDS, PSYD, HSPP, CLINICAL PSYCHOLOGIST, LLC
Active
Other names
Dr. Carol Edwards
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL B EDWARDS PSYD HSPP (CLINICAL PSYCHOLOGIST)
(219) 791-1006
Entity
Organization
Contact information
Practice address
9111 BROADWAY, SUITE N, MERRILLVILLE, IN 46410-8122
(219) 791-1006
(219) 791-1007
Mailing address
PO BOX 1156, VALPARAISO, IN 46384-1156
(219) 791-1006
(219) 791-1007
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
20041414A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11388127
CAQH
IN
01
—
1639142516
NPI INDIVIDUAL PROVIDER
IN
05
—
200337570A
—
IN
Enumeration date
11/07/2008
Last updated
11/07/2008
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