Kelly Harold Edwards, LMFT A, LPC INTERN

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

203393 Issued in TX

Practice address

4807 Spicewood Springs Rd
Building 1, #1140
Austin, TX 78759

Phone

(512) 843-7665

NPI assigned

Oct 1, 2019

Last updated

Oct 1, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Just Mind, PLLC

  • Professional Counselor
  • Austin, TX
  • NPI 1962828236
  NPD
• NPI 1962860544

  • NPI 1962860544
  NPD (past)

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1245871201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 SPICEWOOD SPRINGS RD",
            "address_2": "BUILDING 1, #1140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78759",
            "telephone_number": "512-843-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 SPICEWOOD SPRINGS RD",
            "address_2": "BUILDING 1, #1140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78759",
            "telephone_number": "512-843-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KELLY",
        "middle_name": "HAROLD",
        "credential": "LMFT A, LPC INTERN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "81634",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "203393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaspin T Edwards, LVN
• Jennifer Lynn Edwards, MA
• Jessica I Edwards, D.O.
• Jode Edwards, LCSW
• Kathleen D Edwards
• Kyndal Edwards, PSYD
• Lee Andrew Edwards, PH.D.
• Lee Thomas Edwards, PH.D.
• Lisa Anne Edwards, OTR
• Lynnea Elisabeth Edwards, APRN, AGCNS-BC

• Marriage & Family Therapist in Austin, TX
• Providers in Austin, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.