Provider Demographics
NPI:1053339143
Name:EDWARDS, CARRIE (LMSW)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 ADAMS ST
Mailing Address - Street 2:APT 309
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2216
Mailing Address - Country:US
Mailing Address - Phone:917-566-6599
Mailing Address - Fax:
Practice Address - Street 1:250 5TH AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6405
Practice Address - Country:US
Practice Address - Phone:212-537-6419
Practice Address - Fax:212-532-5125
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0662961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical