Raquel Latrice Edwards, LLMSW, CAADC-DP

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801107671 Issued in MI

Practice address

2 Crocker Blvd Ste 101
Mount Clemens, MI 48043-2558

Phone

(586) 468-2266

Fax

(586) 468-4505

NPI assigned

Jun 23, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Comprehensive Youth Services Inc

  • Community/Behavioral Health Agency
  • Mount Clemens, MI
  • NPI 1750400065
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1104495159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20812 LITTLESTONE RD APT 2",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "482252332",
            "telephone_number": "586-945-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CROCKER BLVD STE 101",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432558",
            "telephone_number": "586-468-2266",
            "fax_number": "586-468-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "RAQUEL",
        "middle_name": "LATRICE",
        "credential": "LLMSW, CAADC-DP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801107671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacia Dzikunu, D.O.
• Earl G Moehn M D P C
• Sydney Morgan Edinger, MD
• Eds Associates
• Emily W. Edwards, LLMSW
• Mary Anne Eineichner, APRN
• Linda El Amin
• Hadi El Ammar, MD
• Eman Ahmed El Sawalhy, MD
• Nawal Azhari Elbashir, MD

• Social Worker in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.