Individual provider Active NPI

Karen Lenore Edwards, PH/D/

  • Psychologist
  • Mason, OH
National Provider Identifier
1144660655
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3292 Issued in OH
Practice address
6404 Thornberry CT
Suite 430
Mason, OH 45040-3502
Phone
(513) 229-7585
Fax
(513) 229-7731
NPI assigned
Jun 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3292 OH Primary

Addresses

Primary practice location

6404 Thornberry CT
Suite 430
Mason, OH 45040-3502

Mailing address

6404 Thornberry CT
Suite 430
Mason, OH 45040-3502
Phone (513) 229-7585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190618002037 OH Practitioner - Clinical Psychologist 6204169691 Practice locations: Brookville, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Psychiatric Services, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1144660655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 THORNBERRY CT",
            "address_2": "SUITE 430",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403502",
            "telephone_number": "513-229-7585",
            "fax_number": "513-229-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 THORNBERRY CT",
            "address_2": "SUITE 430",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403502",
            "telephone_number": "513-229-7585",
            "fax_number": "513-229-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KAREN",
        "middle_name": "LENORE",
        "name_prefix": "Mrs.",
        "credential": "PH/D/",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "3292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.