Andrea M. Edgmon, LCSW, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ANDREA M. EDGMON, LCSW, PLLC

Practice address

313 S Rogers St Ste C
Clarksville, AR 72830-3741

Phone

(479) 388-0032

NPI assigned

Sep 13, 2022

Organization subpart

No

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

Authorized official

Name

Andrea Edgmon, LCSW

Title

President/Clinical Social Worker

Phone

(479) 214-0456

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1457073801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 COUNTY ROAD 3299",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728308268",
            "telephone_number": "479-214-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S ROGERS ST STE C",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303741",
            "telephone_number": "479-388-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA M. EDGMON, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "EDGMON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PRESIDENT/CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "479-214-0456",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Air Evac EMS Inc
• Airways Medical LLC
• George Allen, LCSW
• Keelee Allen, QBHP
• Leonela Alvarado
• Angela Styles MD Dermatology & Dermatopathology PLLC
• Andrew Ankney
• Arcare
• Archway Chiropractic Health Inc
• Area Agency on Aging of Western Arkansas, Inc

• All providers in Clarksville, AR
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.