| Dr. Carol Edwards | |
|
9111 Broadway Suite N Merrillville IN 46410-8122 | |
| (219) 791-1006 | |
| (219) 791-1007 |
| Full Name | Dr. Carol Edwards |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 9111 Broadway, Merrillville, Indiana |
| Authorized Official Name and Position | Carol B Edwards (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2197911006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Carol Edwards Po Box 1156 Valparaiso IN 46384-1156 Ph: (219) 791-1006 | Dr. Carol Edwards 9111 Broadway Suite N Merrillville IN 46410-8122 Ph: (219) 791-1006 |
| NPI Number | 1801040530 |
|---|---|
| Provider Enumeration Date | 11/07/2008 |
| Last Update Date | 11/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801040530 | NPI | - | NPPES |
| 11388127 | Other | IN | CAQH |
| 200337570A | Medicaid | IN | |
| 1639142516 | Other | IN | NPI INDIVIDUAL PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 20041414A (Indiana) | Primary |
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