Provider Demographics
NPI:1225491137
Name:EDGAR-MEANS, CHRISTOPHER EVERAGE
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:EVERAGE
Last Name:EDGAR-MEANS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:EVERAGE
Other - Last Name:EDGAR-SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20997 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-6662
Mailing Address - Country:US
Mailing Address - Phone:248-943-6285
Mailing Address - Fax:
Practice Address - Street 1:20997 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-6662
Practice Address - Country:US
Practice Address - Phone:248-943-6285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011078261041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator