Theresa Diane Edwards, LSW
Individual provider Active NPI Social Worker · Braddock, PA
NPI 1003138645 · NPPES record last updated Sep 13, 2012
Key facts
- NPI
- 1003138645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- SW127377 (PA)
- Practice address
- 445 4TH St
Second Floor
Braddock, PA 15104-1463 - Phone
- (412) 583-9681
- NPI assigned
- Feb 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW127377 | PA | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW127377 | PA | Yes |
Addresses
Primary practice location
445 4TH St
Second Floor
Braddock, PA 15104-1463
Mailing address
445 4TH St
Second Floor
Braddock, PA 15104-1463
Phone (412) 583-9681
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1024653590003 | Medicaid | PA |
Other providers in Braddock, PA
- Shanna M Cochran
- Dominique K Davis
- Marie Elizabeth Devlin
- Alice Mae Dozzi
- Sonja Eckstrom
- Family Above All Home Care LLC
- Jeffrey D Fleming
- Gateway Rehabilitation Center
- Gateway Rehabilitation Center - Cece'S Place
- Gateway Rehabilitation Center-Braddock
All providers in Braddock, PA · Social Worker in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.