Jacquelin Renee Edwards, LBSW

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

60200 Issued in TX

Practice address

341 Hollywood Dr
Edinburg, TX 78539-6117

Phone

(956) 802-1170

Fax

(956) 318-0137

NPI assigned

Nov 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Advancing Together

  • Case Management Agency
  • Edinburg, TX
  • NPI 1295051191
  NPD (past)

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1750047239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 HOLLYWOOD DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785396117",
            "telephone_number": "956-802-1170",
            "fax_number": "956-318-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 HOLLYWOOD DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785396117",
            "telephone_number": "956-802-1170",
            "fax_number": "956-318-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JACQUELIN",
        "middle_name": "RENEE",
        "credential": "LBSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "60200",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "60200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edinburg Pediatric Clinic
• Edinburg Professional Home Health, LLC
• Edinburg Professional Rehabilitation Center, LLC
• Alexander O. Edionwe, RD
• Education Service Center Region I of Texas
• Eeo Sister Enterprises, Inc.
• Victoria Madison Egebrecht
• Natalie Rose Ehret, APRN-CNP
• El Buen Pastor Family Clinic & Wound Care Center
• El Centro Adult Day Care

• Case Manager/Care Coordinator in Edinburg, TX
• Providers in Edinburg, TX by specialty
• Case Manager/Care Coordinator in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.