Active NPI
Deidre Edwards, PH.D.
- Clinical Psychologist
- Bronx, NY
National Provider Identifier
1902203292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 68 020999
- Practice address
- 3411 Wayne Ave
Bronx, NY 10467-2509 - Phone
- (718) 920-2088
- NPI assigned
- Dec 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 68 020999 | NY | Primary |
Addresses
Primary practice location
3411 Wayne Ave
Bronx, NY 10467-2509
Mailing address
3411 Wayne Ave
Bronx, NY 10467-2509
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68 020999 | NY | MD | Clinical Psychologist |
| 020999 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426464000000",
"number": "1902203292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3411 WAYNE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104672509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3411 WAYNE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104672509",
"telephone_number": "718-920-2088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "DEIDRE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-02",
"last_updated": "2015-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "68 020999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.