Edwards, Elizabeth Theola

Edwards, Elizabeth Theola is an sole proprietor health care provider with primary practice located at 1400 Nw 14 Ct. Master Mind Care, Inc. Attn: Elizabeth Edwards, Ft. Lauderdale FL 33311. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Edwards, Elizabeth Theola can be contacted via phone (754) 333-1196.

Contact Information

Primary practice address
1400 Nw 14 Ct. Master Mind Care, Inc. Attn: Elizabeth Edwards Ft. Lauderdale FL 33311
Phone: (754) 333-1196
Fax: (954) 785-6120
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Social Worker 104100000X SW16637 Florida
Behavioral Health & Social Service Providers / School 1041S0200X SW16637 Florida
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW16637 Florida

Profile Details

NPI number 1699984138
LBN Legal business name Edwards, Elizabeth Theola
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 22nd, 2007
Last updated Jul 20th, 2020 - about 6 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 1699984138 NPPES
Florida Other MH684 MEDICARE PROVIDER

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