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Individual

MS. STEPHANIE JO EDMONDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC-MHSP

Contact information

Practice address
4101 E PIERCE ST, PHOENIX, AZ 85008-6413
(423) 284-5926
(866) 583-8017
Mailing address
4101 E PIERCE ST, PHOENIX, AZ 85008-6413
(423) 284-5926
(866) 583-8017

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2470
TN
101YP2500X
Professional Counselor
LPC0000002470
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
259422
NATIONAL CERTIFICATION
05
Q001722
TN
Enumeration date
03/02/2010
Last updated
04/19/2022
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