Shawn Edmontson, CASAC-T

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

31064 Issued in NY

Practice address

2367-69 Second Avenue
New York, NY 10035

Phone

(212) 876-2300

Fax

(212) 722-7618

NPI assigned

May 18, 2016

Last updated

May 18, 2016By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Harlem East Life Plan

  • Community/Behavioral Health Agency
  • New York, NY
  • NPI 1205183191
  NPD (past)

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1225485345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MALCOLM X BLVD",
            "address_2": "APT. 11J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100263001",
            "telephone_number": "212-876-2300",
            "fax_number": "212-722-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2367-69 SECOND AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10035",
            "telephone_number": "212-876-2300",
            "fax_number": "212-722-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONTSON",
        "first_name": "SHAWN",
        "name_prefix": "Mr.",
        "credential": "CASAC-T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "31064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenya Edmonds
• Luwella Martina Edmonds, PA
• Nancy Elizabeth Edmonds, NP
• Philicia Edmonds
• Daniel Edmonston
• Edmot Professional Services
• Victoria Edmund
• Laurel D Edmundson, MD
• Edouard & Associates (Caring Hearts of Charlotte)
• Fabiola Mirienne Edouard, PHARM.D

• Addiction (Substance Use Disorder) Counselor in New York, NY
• Providers in New York, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.