Active NPI
Mary Linda Edwards, LCSW
- Clinical Social Worker
- Lynchburg, VA
National Provider Identifier
1679664015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904000446
- Practice address
- 2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121 - Phone
- (434) 455-3047
- Fax
- (434) 948-4918
- NPI assigned
- Sep 28, 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 | 0904000446 | VA | Primary |
Addresses
Primary practice location
2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121
Mailing address
2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121
Phone (434) 455-3047
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| O84936 | Other | VA | SENTARA |
| 240485 | Other | VA | ANTHEM BLUE SHIELD |
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 |
|---|---|---|---|
| 0904000446 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679664015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 LANGHORNE RD",
"address_2": "SUITE 104",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245011121",
"telephone_number": "434-455-3047",
"fax_number": "434-948-4918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 LANGHORNE RD",
"address_2": "SUITE 104",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245011121",
"telephone_number": "434-455-3047",
"fax_number": "434-948-4918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "MARY",
"middle_name": "LINDA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904000446",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "O84936",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHIELD",
"identifier": "240485",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynchburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.