Active NPI
Ebony Edwards
- Marriage & Family Therapist
- La Plata, MD
National Provider Identifier
1669801247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LGM466
- Practice address
- 6100 Radio Station Road
La Plata, MD 20646-2984 - Phone
- (301) 609-9887
- NPI assigned
- Nov 5, 2013
- Last updated
- Nov 5, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LGM466 | MD | Primary |
Addresses
Primary practice location
6100 Radio Station Road
La Plata, MD 20646-2984
Mailing address
PO Box 2924
La Plata, MD 20646-2984
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 589561800 | Medicaid | MD |
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 |
|---|---|---|---|
| LGM466 | MD | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383609600000",
"number": "1669801247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2924",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206462984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6100 RADIO STATION ROAD",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206462984",
"telephone_number": "301-609-9887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "EBONY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-05",
"last_updated": "2013-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MD",
"license": "LGM466",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "589561800",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Plata, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.