NPIMap

Organization Active NPI

Carol B Edwards, PSYD, HSPP, Clinical Psychologist, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Merrillville, IN
National Provider Identifier
1801040530
Registry record updated Nov 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
20041414A Issued in IN
Legal business name
CAROL B EDWARDS, PSYD, HSPP, CLINICAL PSYCHOLOGIST, LLC
Practice address
9111 Broadway
Suite N
Merrillville, IN 46410-8122
Phone
(219) 791-1006
Fax
(219) 791-1007
NPI assigned
Nov 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2008

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

Authorized official

Name
Dr. Carol B Edwards, PSYD HSPP
Title
Clinical Psychologist
Phone
(219) 791-1006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 20041414A IN Primary

Addresses

Primary practice location

9111 Broadway
Suite N
Merrillville, IN 46410-8122

Mailing address

PO Box 1156
Valparaiso, IN 46384-1156
Phone (219) 791-1006

Other identifiers 3

IdentifierTypeStateIssuer
11388127OtherINCAQH
200337570AMedicaidIN
1639142516OtherINNPI INDIVIDUAL PROVIDER

Other names 1

  • Dr. Carol Edwards Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226016000000",
    "number": "1801040530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1156",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463841156",
            "telephone_number": "219-791-1006",
            "fax_number": "219-791-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 BROADWAY",
            "address_2": "SUITE N",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108122",
            "telephone_number": "219-791-1006",
            "fax_number": "219-791-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL B EDWARDS, PSYD, HSPP, CLINICAL PSYCHOLOGIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-07",
        "last_updated": "2008-11-07",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "219-791-1006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD HSPP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "20041414A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11388127",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200337570A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL PROVIDER",
            "identifier": "1639142516",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Carol Edwards",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; 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.