Edge Therapy and Life Coaching

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EDGE THERAPY AND LIFE COACHING

Practice address

3616 N Meridian Ave Ste 111
Oklahoma City, OK 73112-2814

Phone

(909) 202-8403

Fax

(909) 697-2887

NPI assigned

May 16, 2025

Organization subpart

No

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

Authorized official

Name

Monique Bautista, LCSWNPI 1033800560

Title

Director

Phone

(909) 202-8361

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Monique Bautista, LCSW

  • Clinical Social Worker
  • Fontana, CA
  • NPI 1033800560
  NPD Authorized official

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

{
    "created_epoch": "1747353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1982495925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 CHERRY AVE STE 205",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365362",
            "telephone_number": "909-202-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3616 N MERIDIAN AVE STE 111",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122814",
            "telephone_number": "909-202-8403",
            "fax_number": "909-697-2887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6101 Cherry Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923365362",
            "country_code": "US",
            "telephone_number": "909-202-8361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EDGE THERAPY AND LIFE COACHING",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-16",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "909-202-8361",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1033800560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey L Eden
• Tierney Eden
• Jessica Leeann Edens, LMT
• R. Erik Edens, MD
• Chelsie Edgar, RBT
• Mysti Nicole Edge
• Ngwese Edie
• Elizabeth N Edling, LPC
• Edmed
• William Bentley Edmonds, M.D.

• Clinical Social Worker in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.