Individual provider Active NPI

Cynthia Dee Edwards, LCSW

  • Clinical Social Worker
  • Archdale, NC
National Provider Identifier
1902886823
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C001012 Issued in NC
Practice address
10547 N Main St
Suite a
Archdale, NC 27263-2883
Phone
(336) 431-1888
Fax
(336) 431-2217
NPI assigned
Jan 18, 2006
Last updated
Feb 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C001012 NC Primary

Addresses

Primary practice location

10547 N Main St
Suite a
Archdale, NC 27263-2883

Mailing address

PO Box 4776
Archdale, NC 27263-4776
Phone (336) 431-1888

Other identifiers 2

IdentifierTypeStateIssuer
6002865MedicaidNC
30091OtherNCBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405000221 NC Practitioner - Clinical Social Worker 7517914351 Practice locations: Kernersville, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Kernersville, NC 27284
Phone (336) 403-8211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C001012NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sandhills Center for Mental Health, Developmental Disabilities and Sub Past Accepting new patients
Sandhills Center for Mental Health, Developmental Disabilities and Sub Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1902886823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4776",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272634776",
            "telephone_number": "336-431-1888",
            "fax_number": "336-431-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10547 N MAIN ST",
            "address_2": "SUITE A",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272632883",
            "telephone_number": "336-431-1888",
            "fax_number": "336-431-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CYNTHIA",
        "middle_name": "DEE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002865",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "30091",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Archdale, NC

Sources for this page

Verify at the official NPI Registry.