Provider Demographics
NPI:1841319951
Name:EDGAR, JAMES W (LMFT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:EDGAR
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6102 CORINTH DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-7545
Mailing Address - Country:US
Mailing Address - Phone:719-569-0292
Mailing Address - Fax:719-444-0253
Practice Address - Street 1:2790 N ACADEMY BLVD STE 312
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5347
Practice Address - Country:US
Practice Address - Phone:719-569-0292
Practice Address - Fax:719-444-0253
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT 588106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90531256Medicaid