Bridgette Leora Spann Edwards, LCSW, LCAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008190A Issued in IN

Practice address

4818 Indianapolis Blvd
East Chicago, IN 46312-3433

Phone

(219) 397-5117

Fax

(219) 397-4737

NPI assigned

Feb 16, 2007

Last updated

Nov 2, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Epiphany & Company Counseling Services

  • Counselor
  • Merrillville, IN
  • NPI 1295206746
  NPD

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1174667745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 MCCOOK AVE",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123552",
            "telephone_number": "219-398-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4818 INDIANAPOLIS BLVD",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123433",
            "telephone_number": "219-397-5117",
            "fax_number": "219-397-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANN EDWARDS",
        "first_name": "BRIDGETTE",
        "middle_name": "LEORA",
        "credential": "LCSW, LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000232A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008190A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Smith
• David Soderquist
• Southlake Community Mental Health Center Inc.
• Southlake Community Mental Health Center, Inc (Regional Health Clinic)
• Scarlet Rae Spain, MSN, FNP-BC
• Spine & Musculoskeletal Center PC (Superior Orthopedics)
• Joseph Phillip Spott, D.O.
• St Catherine Hospital Inc
• St Catherine Hospital Inc (Powers Health Pharmacy)
• St Catherine Hospital Inc

• Clinical Social Worker in East Chicago, IN
• Providers in East Chicago, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.