John Joseph Edwards, PH.D.
Individual provider Active NPI Clinical Psychologist · Sugar Hill, GA
NPI 1740451970 · NPPES record last updated Mar 15, 2008
Key facts
- NPI
- 1740451970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY002084 (GA)
- Practice address
- 215 Beech Tree Holw
Sugar Hill, GA 30518-8005 - Phone
- (678) 765-7322
- NPI assigned
- Mar 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY002084 | GA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY002084 | GA | Yes |
Addresses
Primary practice location
215 Beech Tree Holw
Sugar Hill, GA 30518-8005
Mailing address
215 Beech Tree Holw
Sugar Hill, GA 30518-8005
Phone (678) 765-7322
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY002084 | Other | GA | PSYCHOLOGY |
Other providers in Sugar Hill, GA
- Destined Horizons, Inc
- Natasha Diaz-Vidal
- Latoya Drayton
- Barbara An Eason
- Edlyn Healthcare Services, Inc
- Brandon William Faieta
- Family and Youth Interventions, LLC
- Favor Hospice Care LLC
- Asma Ferdous
- Lori G Fiore
All providers in Sugar Hill, GA · Clinical Psychologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.