Edgecare 360 LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EDGECARE 360 LLC

Practice address

2470 Windy Hill Rd SE Ste 300
Marietta, GA 30067-8621

Phone

(770) 933-5328

NPI assigned

Feb 8, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Jennifer Edge, LCSWNPI 1467920975

Title

Ceo/Owner

Phone

(910) 212-2496

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Edge, LCSW

  • Clinical Social Worker
  • Marietta, GA
  • NPI 1467920975
  Medicare reassignment Care Compare group NPD Authorized official
• Regina W Holley, LPC

  • Mental Health Counselor
  • Bainbridge, GA
  • NPI 1356037915
  Medicare reassignment Care Compare group NPD
• Gilda Moss-Traore, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Marietta, GA
  • NPI 1619368107
  Medicare reassignment Care Compare group NPD
• Santissa Tenise Clapp, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
  • NPI 1467053298
  Medicare reassignment
• Julia Cook

  • Counselor
  • Atlanta, GA
  • NPI 1831818939
  NPD
• Charles Finch

  • Mental Health Counselor
  • Atlanta, GA
  • NPI 1881522811
  NPD (past)
• Lanyea Tyus

  • Counselor
  • East Point, GA
  • NPI 1134087596

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1306590328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 FRANKLIN FARMS CIR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143363",
            "telephone_number": "678-561-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 WINDY HILL RD SE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678621",
            "telephone_number": "770-933-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGECARE 360 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-08",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "EDGE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "910-212-2496",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Echols, LAPC
• Savannah Eddy, COA
• Juan La Farrell Edgar
• Karlyn R Edgar, LPC
• Jennifer Edge, LCSW
• Paul Avayonde Edjua, M.D
• Allie Edmiston, NP
• Ravindra Edupuganti, M.D.
• Alice Marie Edwards, LMFT
• Andrew Wayne Edwards, LPC

• Mental Health Counselor in Marietta, GA
• Providers in Marietta, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.