Active NPI
Janis T. Edwards, LISW
- Clinical Social Worker
- Fayetteville, AR
National Provider Identifier
1669411682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1882-C
- Practice address
- 1100 N College Ave
Fayetteville, AR 72703 - Phone
- (479) 443-4301
- NPI assigned
- Jun 5, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1882-C | AR | Primary |
Addresses
Primary practice location
1100 N College Ave
Fayetteville, AR 72703
Mailing address
PO Box 2429
Smyrna, TN 37167-1719
Other practice location 1
4301 Sergeant Rd
Sioux City, IA 51106-4710
Phone (712) 274-4200
Other practice location 2
1100 N College Ave
Fayetteville, AR 72703
Phone (479) 443-4301
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 627 | IA | MD | Counseling Psychologist |
| 1882-C | AR | MD | Clinical Social Worker |
| 00627 | IA | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Medical Services | Past | Accepting new patients | |
| Ven Mental Health and TMS Clinic LLC | Clinical | Past | Accepting new patients |
| Associates for Psychiatric Services PC | Clinical | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Counselor
- Sioux City, IA
- NPI 1134161151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568678400000",
"number": "1669411682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2429",
"city": "SMYRNA",
"state": "TN",
"postal_code": "371671719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 N COLLEGE AVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "72703",
"telephone_number": "479-443-4301"
}
],
"practiceLocations": [
{
"address_1": "4301 Sergeant Rd",
"address_purpose": "LOCATION",
"city": "Sioux City",
"state": "IA",
"postal_code": "511064710",
"country_code": "US",
"telephone_number": "712-274-4200",
"fax_number": "712-274-4217",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1100 N College Ave",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "AR",
"postal_code": "72703",
"country_code": "US",
"telephone_number": "479-443-4301",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDWARDS",
"first_name": "JANIS",
"middle_name": "T.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-05",
"last_updated": "2019-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "1882-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.