Jennifer Edge, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007295 Issued in GA

Practice address

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

Phone

(770) 933-5328

Fax

(470) 980-0507

NPI assigned

Nov 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other names 1

• Edgecare 360 LLC Professional name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Edgecare 360 LLCGroup PAC ID 1658758396, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Edgecare 360 LLC

  • Mental Health Counselor
  • Marietta, GA
  • NPI 1306590328
  Medicare reassignment Care Compare group NPD Authorized official
• Serenity Community Services

  • Community/Behavioral Health Agency
  • NPI 1477889749

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1467920975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 WINDY HILL RD",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678430",
            "telephone_number": "770-933-5328",
            "fax_number": "470-980-0507"
        },
        {
            "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",
            "fax_number": "470-980-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": "CSW007295",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDGECARE",
            "last_name": "360 LLC",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Edith Nkechinyere Eche
• Brittany Echols, LAPC
• Savannah Eddy, COA
• Juan La Farrell Edgar
• Karlyn R Edgar, LPC
• Edgecare 360 LLC
• Paul Avayonde Edjua, M.D
• Allie Edmiston, NP
• Ravindra Edupuganti, M.D.
• Alice Marie Edwards, LMFT

• Clinical Social Worker in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.