Provider Demographics
NPI:1902554066
Name:EDMONDS, KATRINA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:
Last Name:EDMONDS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7169
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-0169
Mailing Address - Country:US
Mailing Address - Phone:267-766-3188
Mailing Address - Fax:267-774-5105
Practice Address - Street 1:1800 ASHBOURNE RD
Practice Address - Street 2:VIRTUAL PRACTICE
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027
Practice Address - Country:US
Practice Address - Phone:267-766-3188
Practice Address - Fax:267-774-5105
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000766106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist