Individual provider Active NPI

Melissa S. Edwards, LCSW

  • Clinical Social Worker
  • Mandeville, LA
National Provider Identifier
1215083977
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4796 Issued in LA
Practice address
900 Wilkinson St
Mandeville, LA 70448-3533
Phone
(985) 624-4450
Fax
(985) 624-4461
NPI assigned
Jan 26, 2007
Last updated
May 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4796 LA Primary

Addresses

Primary practice location

900 Wilkinson St
Mandeville, LA 70448-3533

Mailing address

900 Wilkinson St
Mandeville, LA 70448-3533
Phone (985) 624-4450

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4796LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Department of Health, Department of Health and Hospitals PastSince Nov 3, 2008 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1215083977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WILKINSON ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483533",
            "telephone_number": "985-624-4450",
            "fax_number": "985-624-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILKINSON ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483533",
            "telephone_number": "985-624-4450",
            "fax_number": "985-624-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MELISSA",
        "middle_name": "S.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "4796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.