Active NPI
Kassandra Edmondson
- Mental Health Counselor
- Phoenix, AZ
National Provider Identifier
1013856178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 23701
- Practice address
- 2850 N 24TH St
Phoenix, AZ 85008-1004 - Phone
- (602) 266-5976
- NPI assigned
- Mar 25, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 23701 | AZ | Primary |
Addresses
Primary practice location
2850 N 24TH St
Phoenix, AZ 85008-1004
Mailing address
4122 E McLellan Rd Unit 11
Mesa, AZ 85205-3115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23701 | AZ | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774396800000",
"number": "1013856178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4122 E MCLELLAN RD UNIT 11",
"city": "MESA",
"state": "AZ",
"postal_code": "852053115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2850 N 24TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850081004",
"telephone_number": "602-266-5976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMONDSON",
"first_name": "KASSANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-25",
"last_updated": "2026-03-25",
"certification_date": "2026-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "23701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.