Individual ProviderTimothy Ray EdwardsCounselorBehavioral Health & Social Service ProvidersPractice Address3898 Via Poinciana Drive, Suite 13, Lake Worth, FL 33467-2951(561) 967-2566PECOS EnrollmentBased on the most recent information from CMS, provider Timothy Ray Edwards does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1487929352Provider TypeIndividualFull NameEdwards, Timothy RayTitleDr.CredentialPH.D.GenderMaleSole ProprietorYesEnumeration Date3/12/2012Last Updated3/12/2012Contact InformationPractice LocationPractice Address3898 Via Poinciana Drive, Suite 13, Lake Worth, FL 33467-2951Phone(561) 967-2566Fax(561) 967-4556Mailing LocationMailing Address3898 Via Poinciana Drive, Suite 13, Lake Worth, FL 33467-2951Phone(561) 967-2566Fax(561) 967-4556Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseMH0002581Florida