Clinton Jamie Edwards, MA, M.Ed, LCAS, CSI
Counselor, Addiction (Substance Use Disorder) in Mount Airy, NC. Individual provider (NPI-1).
NPI number1376108191
StatusActive
Last updated in NPPESMar 7, 2022
Details
- NPI
- 1376108191
- Entity type
- Individual (NPI-1)
- Name
- Mr. Clinton Jamie Edwards
- Credential
- MA, M.Ed, LCAS, CSI
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 7, 2019
- Certification date
- Mar 7, 2022
- Last updated
- Mar 7, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | LCAS-2133 | NC | Yes |
Practice location
1151 W Lebanon St Ste 200Mount Airy, NC 27030-2225
Phone 276-728-6703
Mailing address
6776 Snake Creek RdHillsville, VA 24343-4586
Phone 276-728-6703
Other practice locations
3169 North Carolina Highway South
Walnut Cove, NC 27052
Walnut Cove, NC 27052
Phone 336-306-4636
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