Individual provider Active NPI

Lee C. Edwards, PH.D.

  • Psychologist
  • Milledgeville, GA
National Provider Identifier
1295883544
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY000402 Issued in GA
Practice address
700 W Thomas St
Milledgeville, GA 31061-2672
Phone
(478) 452-4969
Fax
(478) 452-0807
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY000402 GA Primary

Addresses

Primary practice location

700 W Thomas St
Milledgeville, GA 31061-2672

Mailing address

254 Salem Church Rd SW
Milledgeville, GA 31061-5901
Phone (478) 452-4969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY000402GAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295883544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 SALEM CHURCH RD SW",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310615901",
            "telephone_number": "478-452-4969",
            "fax_number": "478-452-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W THOMAS ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612672",
            "telephone_number": "478-452-4969",
            "fax_number": "478-452-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "LEE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY000402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milledgeville, GA

Sources for this page

Verify at the official NPI Registry.