Individual provider Active NPI

Courtney Cherise Edge, LBSW,

  • Social Worker
  • Detroit, MI
National Provider Identifier
1194215020
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6852090430 Issued in MI
Practice address
8600 Woodward Ave
Detroit, MI 48202-2142
Phone
(313) 875-7601
Fax
(313) 871-1891
NPI assigned
May 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6852090430 MI Primary

Addresses

Primary practice location

8600 Woodward Ave
Detroit, MI 48202-2142

Mailing address

8600 Woodward Ave
Detroit, MI 48202-2142
Phone (313) 875-7601

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

State licenses

LicenseStateTypeSpecialty
6852090430MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
National Council on Alcoholism & Drug Dependence Greater Detroit Addiction (Substance Use Disorder) Past Accepting new patients
National Council on Alcoholism Drug Dependence Past Accepting new patients

Organizations & group practices 2

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": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1194215020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022142",
            "telephone_number": "313-875-7601",
            "fax_number": "313-871-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022142",
            "telephone_number": "313-875-7601",
            "fax_number": "313-871-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "COURTNEY",
        "middle_name": "CHERISE",
        "name_prefix": "Mrs.",
        "credential": "LBSW,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6852090430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.