Brianna Pine Edwards, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

097502 Issued in NY

Practice address

360 State Route 17M
Monroe, NY 10950-3443

Phone

(909) 713-8733

NPI assigned

Jun 20, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Sep 9, 2024 through Sep 9, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jessica C. Sullivan LCSW, PLLC

  • Clinical Social Worker
  • Monroe, NY
  • NPI 1811532385
  NPD (past)

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1114377264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 STATE ROUTE 17M",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109503443",
            "telephone_number": "909-713-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 STATE ROUTE 17M",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109503443",
            "telephone_number": "909-713-8733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "BRIANNA",
        "middle_name": "PINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097502",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dynamic Center, Inc
• Danielle Theresa Dziedzic, M.D.
• Shannon Early, LCSW
• Eckerd Corporation
• Edamar Ambulette Transpport LLC
• Laura Efinger, OTR/L
• Eisenberger and Adler Orthodontics at Monroe PLLC
• Agnes Eisenberger
• Eldersphere Home Care Services LLC
• Elevate Yourself Inc.

• Clinical Social Worker in Monroe, NY
• Providers in Monroe, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.