Active NPI
Lee Thomas Edwards, PH.D.
- Counseling Psychologist
- Austin, TX
National Provider Identifier
1083621874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 31266
- Practice address
- 4103 Marathon Blvd
100B
Austin, TX 78756-3719 - Phone
- (512) 458-9787
- Fax
- (512) 458-8752
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 31266 | TX | Primary |
Addresses
Primary practice location
4103 Marathon Blvd
100B
Austin, TX 78756-3719
Mailing address
5213 Leralynn St
Austin, TX 78751-1915
Phone (512) 467-0923
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31266 | TX | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083621874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5213 LERALYNN ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787511915",
"telephone_number": "512-467-0923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4103 MARATHON BLVD",
"address_2": "100B",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787563719",
"telephone_number": "512-458-9787",
"fax_number": "512-458-8752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "LEE",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "TX",
"license": "31266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.