Active NPI
Taylor Blake Edwards, LCDC
- Addiction (Substance Use Disorder) Counselor
- Dayton, TX
National Provider Identifier
1508632779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 16715
- Practice address
- 904 FM 686
Dayton, TX 77535-2299 - Phone
- (936) 257-8584
- NPI assigned
- Nov 29, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16715 | TX | Primary |
Addresses
Primary practice location
904 FM 686
Dayton, TX 77535-2299
Mailing address
3306 Abbey Field LN
Porter, TX 77365-8514
Phone (903) 754-3457
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16715 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703635200000",
"number": "1508632779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3306 ABBEY FIELD LN",
"city": "PORTER",
"state": "TX",
"postal_code": "773658514",
"telephone_number": "903-754-3457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 FM 686",
"city": "DAYTON",
"state": "TX",
"postal_code": "775352299",
"telephone_number": "936-257-8584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "TAYLOR",
"middle_name": "BLAKE",
"credential": "LCDC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-29",
"last_updated": "2023-12-27",
"certification_date": "2023-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "16715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.