Individual provider Active NPI

Marissa Noelle Edwards

  • Health Service Psychologist
  • North Chesterfield, VA
National Provider Identifier
1174438857
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
A0491 Issued in MD
Practice address
4605 Landing Cir
North Chesterfield, VA 23236-4730
Phone
(804) 350-4565
NPI assigned
Aug 17, 2026
Last updated
Aug 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X A0491 MD Primary

Addresses

Primary practice location

4605 Landing Cir
North Chesterfield, VA 23236-4730

Mailing address

4605 Landing Cir
North Chesterfield, VA 23236-4730
Phone (804) 350-4565

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

NPI Registry JSON

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

{
    "created_epoch": "1786924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1174438857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 LANDING CIR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232364730",
            "telephone_number": "804-350-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 LANDING CIR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232364730",
            "telephone_number": "804-350-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MARISSA",
        "middle_name": "NOELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-17",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MD",
            "license": "A0491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.