John Roderick Edwards, a Licensed Clinical Social Worker Corporation

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JOHN RODERICK EDWARDS, A LICENSED CLINICAL SOCIAL WORKER CORPORATION

Practice address

2939 Summit St Ste 203
Oakland, CA 94609-3404

Phone

(510) 213-9284

Fax

(510) 285-6457

NPI assigned

Jan 9, 2023

Organization subpart

No

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

Authorized official

Name

Mr. John Roderick Edwards, LCSWNPI 1386902021

Title

President

Phone

(510) 213-9284

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John R Edwards, MSW, LCSW

  • Clinical Social Worker
  • Oakland, CA
  • NPI 1386902021
  NPD Authorized official

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1629782339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946040491",
            "telephone_number": "510-213-9284",
            "fax_number": "510-285-6457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2939 SUMMIT ST STE 203",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093404",
            "telephone_number": "510-213-9284",
            "fax_number": "510-285-6457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN RODERICK EDWARDS, A LICENSED CLINICAL SOCIAL WORKER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-07",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "RODERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-213-9284",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Oakland, CA
• Providers in Oakland, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.

Verify at the official NPI Registry.