NPI 1457073801 · live from the CMS NPI Registry
Andrea M. Edgmon, LCSW, PLLC
Social Worker, Clinical in Clarksville, AR. National Provider Identifier 1457073801, active.
NPI record
| NPI | 1457073801 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 313 S Rogers St Ste C, Clarksville, AR 72830 |
| Practice phone | 479-388-0032 |
| Mailing address | 299 County Road 3299, Clarksville, AR 72830 |
| Enumerated | September 13, 2022 |
| Last updated | September 13, 2022 |
| Authorized official | Andrea Edgmon, President/Clinical Social Worker |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.