Larry Edwards, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851108048 Issued in MI

Practice address

2081 W Grand Blvd
Detroit, MI 48208-1105

Phone

(313) 895-0500

Fax

(313) 895-4425

NPI assigned

Dec 31, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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.

• Sobriety House

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
  • NPI 1386777555
  NPD (past)

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1962890780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2081 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081105",
            "telephone_number": "313-895-0500",
            "fax_number": "313-895-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081105",
            "telephone_number": "313-895-0500",
            "fax_number": "313-895-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "LARRY",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-31",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "SA 820123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851108048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliene Wilkinson Edwards, LLMSW
• Kelsey Rae Edwards, PSYD
• Kelvyna Edwards
• Keshia Edwards, PMHNP
• Larry Edwards
• Matthew Edwards, PA-C
• Melissa Edwards, LLMSW
• Melissa Nicole Edwards
• Morgan Edwards
• Nami O Edwards, CRNA

• All providers in Detroit, MI
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.