Provider Demographics
NPI:1962389403
Name:HARTFORD EDWARDS, JUANITA (CHRISTIAN COUNSELING)
Entity type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:
Last Name:HARTFORD EDWARDS
Suffix:
Gender:F
Credentials:CHRISTIAN COUNSELING
Other - Prefix:
Other - First Name:JUANITA
Other - Middle Name:
Other - Last Name:HARTFORD EDWARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:248 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:GA
Mailing Address - Zip Code:31320-4596
Mailing Address - Country:US
Mailing Address - Phone:912-610-1142
Mailing Address - Fax:912-442-3147
Practice Address - Street 1:248 BUTLER ST
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:GA
Practice Address - Zip Code:31320-4596
Practice Address - Country:US
Practice Address - Phone:912-610-1142
Practice Address - Fax:912-442-3147
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral