Individual provider · Type 1 NPI

Dominiquea Edmiston, LCSW

Clinical Social Worker · Statesville, NC

NPI number 1619618212 Active

Practice location

806 Phillips Ln
Statesville, NC 28625-4596

Other practice locations

  • 1115 E Lemon St, Tempe, AZ 85281-4028 · (602) 525-7997

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000X18434 (AZ)
Clinical Social Worker Primary 1041C0700X20424 (AZ)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1619618212

Dominiquea Edmiston, LCSW's National Provider Identifier is 1619618212, issued on Apr 6, 2022. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Statesville, NC. The record was last updated on Aug 4, 2024.