Active NPI
Stephanie Danielle Edwards, LPCC-S
- Professional Counselor
- Bowling Green, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 104235
- Practice address
- 380 Suwannee Trail St
Bowling Green, KY 42103-7956 - Phone
- (270) 901-5000
- Fax
- (270) 842-5268
- NPI assigned
- Aug 9, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 104235 | KY | Primary |
Addresses
Primary practice location
380 Suwannee Trail St
Bowling Green, KY 42103-7956
Mailing address
380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone (270) 901-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100289610 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
512 Veterans Memorial Hwy
Scottsville, KY 42164-8443
Phone (270) 901-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeskills, Inc. | Current | Accepting new patients |
Locations
8324 Eagle Way
Chicago, IL 60678
822 Woodway St
Bowling Green, KY 42101
380 Suwannee Trail St
Bowling Green, KY 42103
1031 Brookhaven Rd
Franklin, KY 42134
Phone (270) 586-8281
608 Happy Valley Rd
Glasgow, KY 42141
Phone (270) 651-8379
512 Veterans Memorial Hwy
Scottsville, KY 42164
Phone (270) 237-4481
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Bowling Green, KY
- NPI 1669401816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1750660650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 SUWANNEE TRAIL ST",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421037956",
"telephone_number": "270-901-5000",
"fax_number": "270-842-5268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 SUWANNEE TRAIL ST",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421037956",
"telephone_number": "270-901-5000",
"fax_number": "270-842-5268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "STEPHANIE",
"middle_name": "DANIELLE",
"credential": "LPCC-S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-09",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "104235",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100289610",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.