David Tinman Edgar, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

L11134 Issued in OR

Practice address

7011 SE 44TH Ave
Portland, OR 97206-7700

Phone

(503) 544-7773

NPI assigned

Mar 8, 2025

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1741392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741392000000",
    "number": "1174322697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 SE 44TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972067700",
            "telephone_number": "503-544-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 SE 44TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972067700",
            "telephone_number": "503-544-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGAR",
        "first_name": "DAVID",
        "middle_name": "TINMAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-08",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "23-02-20248",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L11134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Edelschick, MSW, CADC I
• Robert Alan Edelstein, LMFT, MFT
• Eden Family Wellness Prof Corp
• Christopher Owen Eden, MD
• Jessica Eden, LMT
• Scott W Edgar, DMD
• Thomas Edgar, MD
• Edge Performance Fitness LLC
• Kara Edge, MSW
• Patricia Edge, LCSW

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2025; 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.