DR. GENE RANDOLPH EDWARDS (NPI# 1659628030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659628030 |
| Entity Type | Individual |
| Full Name | DR. GENE RANDOLPH EDWARDS |
| Credential | PH.D. |
| Practice Address |
1923 J N Pease Pl Suite 204 Charlotte NC 28262-4513 |
| Practice Telephone | 7045033535 |
| Practice Fax Number | 7045935555 |
| Mailing Telephone | 7045033535 |
| Mailing Fax Number | 7045935555 |
| Enumeration Date | 2012-08-05 |
| Last Update Date | 2012-08-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
3660 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NC PSYCHOLOGY BOARD LICENSE NUMBER | 3660 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316175631 | Gene L Edwards | Occupational Therapy Assistant | 410 E 12th St, Alton, IL 62002-7229 | 2009-06-25 |
| Street Address |
1923 J N PEASE PL SUITE 204 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28262-4513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295768943 | Psychological Services of Charlotte | Psychologist | 1923 J N Pease Pl, Suite 204, Charlotte, NC 28262-4513 | 2006-07-08 |
| 1447869763 | Glacia Ethridge | Counselor | 1923 J N Pease Pl, Charlotte, NC 28262-4513 | 2020-07-23 |
| 1588205124 | Aspire Life Services, Pllc | Counselor | 1923 J N Pease Pl, Charlotte, NC 28262-4513 | 2019-10-04 |
| 1083000202 | Emily Jeffries | Counselor | 1923 J N Pease Pl, Suite 104, Charlotte, NC 28262-4513 | 2015-04-14 |
| 1831510965 | Rachel Stout | Counselor | 1923 J N Pease Pl, Ste 104, Charlotte, NC 28262-4513 | 2013-12-16 |
| 1124371372 | Healing Solutions Counseling Center, Pllc | Counselor | 1923 J N Pease Pl, Suite 104, Charlotte, NC 28262-4513 | 2012-10-24 |
| 1417185380 | Kristin M Grasso | Psychologist | 1923 J N Pease Pl, Suite 204, Charlotte, NC 28262-4513 | 2009-06-30 |
| 1275780892 | Kimberly Marie Coons | Marriage & Family Therapist | 1923 J N Pease Pl, Suite 104, Charlotte, NC 28262-4513 | 2008-08-26 |
| 1528250164 | Sarah Millman Carley | Counselor | 1923 J N Pease Pl, Suite 204, Charlotte, NC 28262-4513 | 2007-08-17 |
| 1730397191 | Matthew S. Burgess Leary | Psychologist | 1923 J N Pease Pl, Suite 204, Charlotte, NC 28262-4513 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056913 | Aleta Michelle Johnson | Specialist | 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 | 2020-09-01 |
| 1275161580 | Londyn Homecare Agency L.l.c | Home Health | 1914j.n. Place, Charlotte, NC 28262 | 2020-03-31 |
| 1154964914 | Abundant Love Home Care Service LLC | In Home Supportive Care | 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 | 2019-10-24 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1114404506 | Laura Ida Anthony-getant | Social Worker | 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 | 2018-07-27 |
| 1720573587 | Carolinas Center for Ambulatory Dentistry LLC | Dentist | 8415 Medical Plaza Drice, Charlotte, NC 28262 | 2018-06-25 |
| 1598254799 | Cassandra Faye Harding | Nurse Practitioner | 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 | 2018-05-03 |
| 1669960746 | Michael Riley | In Home Supportive Care | 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 | 2018-04-25 |
| 1568989804 | Bridget Coomber | Behavior Technician | 8420 University Executive Dr Ste 810, Charlotte, NC 28262 | 2017-08-28 |
| 1073037701 | Toshana Daley | Physical Therapist | 8801 Jm Keynes Blvd, Charlotte, NC 28262 | 2017-08-03 |
| Find all providers in zip 28262 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770148751 | Personal Enrichment Counseling & Consulting Services, Pllc | Psychologist | 10130 Mallard Creek Rd Ste 320, Charlotte, NC 28262-6001 | 2019-05-06 |
| 1932610177 | Charlotte Center for Balanced Living, P.a. | Psychologist | 5970 Fairview Rd Ste 412, Charlotte, NC 28210-2105 | 2017-10-16 |
| 1508281064 | Jeffrey Steven Martin | Psychologist | 300 Palmer Ln, Charlotte, VT 05445-4410 | 2014-02-20 |
| 1588008148 | Quick Empire, LLC | Psychologist | 3214 Lemongrass Ln, Charlotte, NC 28214-0204 | 2013-04-24 |
| 1548541048 | Shanna Brooke Heun | Psychologist | 501 S Sharon Amity Rd Ste 350, Charlotte, NC 28211-3099 | 2011-08-29 |
| 1932408986 | Vernessa Bowles | Psychologist | 7419 Ponders End Ln, Charlotte, NC 28213-5752 | 2011-03-16 |
| 1053642363 | Carolinas Physicians Network, Inc. | Psychologist | 5435 Prosperity Church Road, Ste 2200, Charlotte, NC 28269-2344 | 2010-01-26 |
| 1922143940 | Amy Fowler Johnson | Psychologist | 4425 Randolph Rd., Suite 411, Charlotte, NC 28211 | 2007-02-20 |
| 1720122757 | Aurora Family Counseling Center | Psychologist | 7110 Brighton Park Dr, Suite 400 Pmb 264, Charlotte, NC 28227-7987 | 2007-02-15 |
| 1487695052 | Brian Ronald Monteleone | Psychologist | 1977 J N Pease Pl, Suite 104, Charlotte, NC 28262-4508 | 2006-06-08 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.