Gwendolyn T Edmond, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC004269 Issued in GA

Practice address

103 Mercer Dr Ste B
Dublin, GA 31021-4257

Phone

(478) 274-3012

Fax

(478) 274-7948

NPI assigned

Aug 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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.

• Laurens County Board of Health

  • Public Health or Welfare Agency
  • Dublin, GA
  • NPI 1841505641
  NPD (past)

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1851870331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 BELLEVUE RD STE B",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212952",
            "telephone_number": "478-274-3012",
            "fax_number": "478-274-7948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MERCER DR STE B",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310214257",
            "telephone_number": "478-274-3012",
            "fax_number": "478-274-7948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMOND",
        "first_name": "GWENDOLYN",
        "middle_name": "T",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Myron Eason, RN
• Easter Seals Middle Georgia
• Sally Nadine Eddins, LCSW
• Robert Edge
• Tammy E. Edge, LPC, EDS
• Kizzy Oliver Edmond, FNP-C
• Ken Von Eiland
• Obioma Joseph Ekeledo, MD
• Elite MRI of Laurens, LLC
• Amanda Ellenberg

• Professional Counselor in Dublin, GA
• Providers in Dublin, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.