Provider Demographics
NPI:1366984858
Name:EDWARDS, CHRIS (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 MANSION RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3406
Mailing Address - Country:US
Mailing Address - Phone:484-416-1206
Mailing Address - Fax:
Practice Address - Street 1:169 MANSION RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3406
Practice Address - Country:US
Practice Address - Phone:484-416-1206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPCO12168101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional