Provider Demographics
NPI:1457080681
Name:EDWARDS, STEPHANIE ELAINE (MSW, LCSW-A)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:ELAINE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-4854
Mailing Address - Country:US
Mailing Address - Phone:910-739-3064
Mailing Address - Fax:
Practice Address - Street 1:900 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-4854
Practice Address - Country:US
Practice Address - Phone:910-739-3064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-04
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0192521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC800903340Medicaid