Individual provider Active NPI

Tanya M Edwards, LCSW

  • Clinical Social Worker
  • Jackson, MS
National Provider Identifier
1538307145
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C7486 Issued in MS
Practice address
248 E Capitol St
Jackson, MS 39201-2503
Phone
(800) 632-6074
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C7486 MS Primary

Addresses

Primary practice location

248 E Capitol St
Jackson, MS 39201-2503

Mailing address

501 Avalon Way
Ste D
Brandon, MS 39047-7500
Phone (601) 951-9863

Other names 1

  • Tanya Marie Edwards Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20240229001527 MA Practitioner - Clinical Social Worker 7012073794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tmin Services IncGroup PAC ID 0840657862, 42 clinicians

Practice addresses (Care Compare)

800 District Ave
Suite 520
Burlington, MA 01803-5060
Phone (781) 338-7350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C7486MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tmin Services, Inc. CurrentSince Jan 24, 2024 Accepting new patients

Locations

800 District Ave
Ste 520
Burlington, MA 01803
Phone (781) 338-7350

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1538307145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 AVALON WAY",
            "address_2": "STE D",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477500",
            "telephone_number": "601-951-9863",
            "fax_number": "601-362-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 E CAPITOL ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392012503",
            "telephone_number": "800-632-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "TANYA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANYA",
            "last_name": "EDWARDS",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.