Individual provider Active NPI

Angela Bonita Edwards, LPC, LCDC

  • Professional Counselor
  • McKinney, TX
National Provider Identifier
1982416905
Registry record updated Jan 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
91872 Issued in TX
Practice address
1402 S Custer Rd Ste 803
McKinney, TX 75072-1453
Phone
(469) 714-7558
NPI assigned
Jan 25, 2025
Last updated
Jan 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17161 TX
Professional Counselor 101YP2500X 91872 TX Primary

Addresses

Primary practice location

1402 S Custer Rd Ste 803
McKinney, TX 75072-1453

Mailing address

PO Box 701204
Dallas, TX 75370-1204
Phone (313) 399-5750

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17161TXMDAddiction (Substance Use Disorder) Counselor
91872TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1737763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737763200000",
    "number": "1982416905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 701204",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753701204",
            "telephone_number": "313-399-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S CUSTER RD STE 803",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750721453",
            "telephone_number": "469-714-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ANGELA",
        "middle_name": "BONITA",
        "credential": "LPC, LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-25",
        "last_updated": "2025-01-25",
        "certification_date": "2025-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "17161",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "91872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2025; 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.