Active NPI
Judith Edmonds, LCSW, LPC
- Clinical Social Worker
- Madison, WI
National Provider Identifier
1538452537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3857-123
- Practice address
- 2120 Fordem Ave
Madison, WI 53704-4696 - Phone
- (608) 729-1114
- NPI assigned
- May 24, 2011
- Last updated
- May 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2161-125 | WI | |
| Clinical Social Worker | 1041C0700X | 3857-123 | WI | Primary |
Addresses
Primary practice location
2120 Fordem Ave
Madison, WI 53704-4696
Mailing address
2120 Fordem Ave
Madison, WI 53704-4696
Phone (608) 729-1114
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 |
|---|---|---|---|
| 2161-125 | WI | MD | Professional Counselor |
| 3857-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306195200000",
"number": "1538452537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2120 FORDEM AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537044696",
"telephone_number": "608-729-1114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 FORDEM AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537044696",
"telephone_number": "608-729-1114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMONDS",
"first_name": "JUDITH",
"name_prefix": "Ms.",
"credential": "LCSW, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-24",
"last_updated": "2011-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "2161-125",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "3857-123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.