Jennifer L Edge, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW02865 Issued in RI

Practice address

1090 Cranston St
Cranston, RI 02920-7323

Phone

(401) 467-9610

NPI assigned

Nov 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Renee Burdett, MD PC

  • Multi-Specialty Clinic/Center
  • Woodbridge, VA
  • NPI 1760540967
  NPD (past)
• TMS Neurohealth Centers Woodbridge LLC

  • Clinic/Center
  • Woodbridge, VA
  • NPI 1942662259
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1497825889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 CRANSTON ST",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029207323",
            "telephone_number": "401-467-9610",
            "fax_number": "401-223-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 CRANSTON ST",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029207323",
            "telephone_number": "401-467-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "146467",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• E.P. Mennillo, M.D., Inc
• Anthony Paul Eacuello
• East Coast Medical, LLC
• Jennifer Ebanks
• Ec Therapy Solutions LLC
• Edgewood Medical LLC
• Sofia Edlund-Wynn
• Edward T. Ferry, DDS Inc
• Merle Edwards-Orr
• Michael S Edwards, DPT

• Clinical Social Worker in Cranston, RI
• Providers in Cranston, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.