Individual provider · Type 1 NPI

Mary Gauden Edmonson, MA, LPC, CAC II, LAC

Professional Counselor · Greenville, SC

NPI number 1881997914 Active

Practice location

3443 Pelham Rd Ste 200
Greenville, SC 29615-4180

Call (864) 612-3004 Map

Fax (864) 558-0059

Mailing address

4 Parkway Commons
Greer, SC 29650-1971

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X721 (SC)
Professional Counselor Primary 101YP2500X5173PC (SC)

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About NPI 1881997914

Mary Gauden Edmonson, MA, LPC, CAC II, LAC's National Provider Identifier is 1881997914, issued on Dec 11, 2010. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Greenville, SC. The record was last updated on Jul 31, 2019.