Individual provider Active NPI

Charlsia Gwynn Brown, LCDC II

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
National Provider Identifier
1023562725
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
001407 Issued in OH
Practice address
1289 E Livingston Ave
Columbus, OH 43205-2838
Phone
(614) 252-8834
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 001407 OH Primary

Addresses

Primary practice location

1289 E Livingston Ave
Columbus, OH 43205-2838

Mailing address

5458 Aspen Rd
Columbus, OH 43229-3802
Phone (614) 832-3548

Other practice location 1

Maryhaven Inc 1791 Alum Creek Dr
Columbus, OH 43207
Phone (614) 445-8131 ext. 217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001407OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023562725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5458 ASPEN RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293802",
            "telephone_number": "614-832-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 E LIVINGSTON AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052838",
            "telephone_number": "614-252-8834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Maryhaven Inc 1791 Alum Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "43207",
            "country_code": "US",
            "telephone_number": "614-445-8131 x217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CHARLSIA",
        "middle_name": "GWYNN",
        "credential": "LCDC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "001407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.