Edwards, Janis L

Edwards, Janis L is an sole proprietor health care provider with primary practice located at 408 Elmore St , Park Ridge IL 60068-3437. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Edwards, Janis L can be contacted via phone (484) 678-3786.

Contact Information

Primary practice address
408 Elmore St Park Ridge IL 60068-3437
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Q1-0000434 Delaware
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 149.014777 Illinois

Profile Details

NPI number 1588711790
LBN Legal business name Edwards, Janis L
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 3rd, 2007
Last updated Nov 3rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588711790 NPPES
Delaware MEDICAID 1000015367

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