| Doctor Name: | LISA MAY EDMONDSON |
| NPI Number: | 1265564645 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | C005608 |
| Business Practice Address: | 106 N 1st Ave Suite A Knightdale, NC - 275458093 |
| Business Phone Number: | 9192104176 |
| Business Fax Number: | 8777574728 |
| Mailing Address: | 106 Arbor Ridge Ct, KNIGHTDALE |
| State: | NC |
| Postal Code: | 275459202 |
| Phone Number: | 9192104176 |
| Fax Number: | 8777574728 |
| NPI Enumeration Date: | 03/12/2007 |
| NPI Last Update Date: | 06/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C005608 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |