Individual
MRS. MARY GAUDEN EDMONSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, CAC II, LAC
Contact information
Practice address
3443 PELHAM RD STE 200, GREENVILLE, SC 29615-4180
(864) 612-3004
(864) 558-0059
Mailing address
4 PARKWAY COMMONS, GREER, SC 29650-1971
(864) 612-3004
(864) 644-1001
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
721
SC
101YP2500X
Professional Counselor
Primary
5173PC
SC
Other
Enumeration date
12/11/2010
Last updated
07/31/2019
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