Theo Edwards

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20136 Issued in OK

Practice address

211 N Highway 59
Kansas, OK 74347-7076

Phone

(918) 786-4434

NPI assigned

Nov 5, 2019

Last updated

Nov 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

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.

• Compass Counseling Services PLLC

  • Clinical Social Worker
  • Fort Gibson, OK
  • NPI 1346724747
  Medicare reassignment NPD
• Grand Lake Mental Health Center, Inc.

  dba GRAND Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, OK
  • NPI 1497762520
  Medicare reassignment NPD
• Grand Lake Mental Health Center Inc

  dba GRAND Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stillwater, OK
  • NPI 1992341671
  NPD
• Grand Lake Mental Health Center, Inc.

  dba Grand Mental Health

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1356048656
  NPD

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764288000000",
    "number": "1194369892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N. HWY 59, KANSAS OK",
            "city": "KANSAS",
            "state": "OK",
            "postal_code": "743470000",
            "telephone_number": "918-786-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N HIGHWAY 59",
            "city": "KANSAS",
            "state": "OK",
            "postal_code": "743477076",
            "telephone_number": "918-786-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "THEO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-05",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "20136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Discover Well-Beings, PLLC (Crossroads Wellness Center and Zena Area Community Clinic)
• Kimberly Nicole Dodson
• Kimberly Dry
• Craig Warner Duff
• Echota Behavioral Health Services, LLC (Echota Behavioral Health-Kansas)
• Melissa L Ellis
• Sarah Elizabeth Ellis
• Alexis Fitts
• Meagan Floyd
• Theresa-Grace Gibbins

• Clinical Social Worker in Kansas, OK
• Providers in Kansas, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2025; 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.