Provider Demographics
NPI:1447345970
Name:WARREN, EDWARD SCOTT (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:SCOTT
Last Name:WARREN
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 COPPER BEECH CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8115
Mailing Address - Country:US
Mailing Address - Phone:919-537-8791
Mailing Address - Fax:919-537-8791
Practice Address - Street 1:213 COPPER BEECH CT
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8115
Practice Address - Country:US
Practice Address - Phone:919-537-8791
Practice Address - Fax:919-537-8791
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2008-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19380101YM0800X
NC7259101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health