Active NPI
Edda Wellness, LLC
- Professional Counselor
- Republic, MO
National Provider Identifier
1932005865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Legal business name
- EDDA WELLNESS, LLC
- Practice address
- 116 W Grant St
Republic, MO 65738-1469 - Phone
- (469) 476-5679
- NPI assigned
- Oct 16, 2026
- Last updated
- Oct 16, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas Silva, LPC
- Title
- Therapist
- Phone
- (469) 476-5679
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | NU | Primary |
Addresses
Primary practice location
116 W Grant St
Republic, MO 65738-1469
Mailing address
18208 Preston Rd
Dallas, TX 75252-6007
Phone (469) 476-5679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1792108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1792108800000",
"number": "1932005865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18208 PRESTON RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752526007",
"telephone_number": "469-476-5679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 W GRANT ST",
"city": "REPUBLIC",
"state": "MO",
"postal_code": "657381469",
"telephone_number": "469-476-5679"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EDDA WELLNESS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-16",
"last_updated": "2026-10-16",
"certification_date": "2026-10-16",
"status": "A",
"authorized_official_last_name": "SILVA",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "THERAPIST",
"authorized_official_telephone_number": "469-476-5679",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Republic, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.