NPIMap

Organization Active NPI

Edwards Mentoring and Social Services, LMSW, P.L.L.C.

  • Community/Behavioral Health Agency
  • Springfield Gardens, NY
National Provider Identifier
1366986812
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
092982 Issued in NY
Legal business name
EDWARDS MENTORING AND SOCIAL SERVICES, LMSW, P.L.L.C.
Doing business as
Edwards Mentoring
Practice address
19005 122ND Ave
Suite a
Springfield Gardens, NY 11413-1010
Phone
(646) 824-5737
NPI assigned
Dec 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Authorized official

Name
Mr. Larry D Edwards, LMSWNPI 1699170365
Title
Founder / Director
Phone
(646) 824-5737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 092982 NY
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X 092982 NY
Case Management Agency 251B00000X 092982 NY
Community/Behavioral Health Agency 251S00000X 092982 NY Primary

Addresses

Primary practice location

19005 122ND Ave
Suite a
Springfield Gardens, NY 11413-1010

Mailing address

19005 122ND Ave
Suite a
Springfield Gardens, NY 11413-1010
Phone (646) 824-5737

Other identifiers 1

IdentifierTypeStateIssuer
1699170365MedicaidNY

Other names 1

  • Edwards Mentoring Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1366986812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19005 122ND AVE",
            "address_2": "SUITE A",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114131010",
            "telephone_number": "646-824-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19005 122ND AVE",
            "address_2": "SUITE A",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114131010",
            "telephone_number": "646-824-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARDS MENTORING AND SOCIAL SERVICES, LMSW, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-16",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "FOUNDER / DIRECTOR",
        "authorized_official_telephone_number": "646-824-5737",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "NY",
            "license": "092982",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "092982",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NY",
            "license": "092982",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "092982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699170365",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edwards Mentoring",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.