Provider Demographics
NPI:1144912106
Name:EDGE COUNSELING & CONSULTING
Entity type:Organization
Organization Name:EDGE COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SPADING
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CRC
Authorized Official - Phone:319-350-0921
Mailing Address - Street 1:309 SUNFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:IA
Mailing Address - Zip Code:52228-7608
Mailing Address - Country:US
Mailing Address - Phone:319-350-0921
Mailing Address - Fax:
Practice Address - Street 1:309 SUNFLOWER DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:IA
Practice Address - Zip Code:52228-7608
Practice Address - Country:US
Practice Address - Phone:319-350-0921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No225CA2500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology SupplierGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury MedicineGroup - Multi-Specialty
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Multi-Specialty