Edwards, Theresa

Edwards, Theresa is an sole proprietor health care provider with primary practice located at 8384 Six Forks Rd Suite 104, Raleigh NC 27615-5079. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Edwards, Theresa can be contacted via phone (919) 845-4550.

Contact Information

Primary practice address
8384 Six Forks Rd Suite 104 Raleigh NC 27615-5079
Phone: (919) 845-4550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1532 North Carolina
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 1532 North Carolina
Behavioral Health & Social Service Providers / School 103TS0200X 1532 North Carolina

Profile Details

NPI number 1457375495
LBN Legal business name Edwards, Theresa
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2006
Last updated Jan 14th, 2014 - about 11 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 1457375495 NPPES
North Carolina Other NONE HEALTH SERVICES PROVIDER
North Carolina Other 1532 HEALTH SERVICES PROVIDER
North Carolina Other 0333A HEALTH SERVICES PROVIDER
North Carolina MEDICAID 6000501 HEALTH SERVICES PROVIDER

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