Charissa Bogle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8177 Issued in TN

Practice address

154 W Springbrook Dr
Johnson City, TN 37604-1758

Phone

(423) 926-1171

NPI assigned

Apr 29, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1033529052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CAMBRIDGESHIRE CT",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154683",
            "telephone_number": "931-249-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 W SPRINGBROOK DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041758",
            "telephone_number": "423-926-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGLE",
        "first_name": "CHARISSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "9891",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "8177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobby D Reynolds II
• Leslie Bodo, FNP-BC
• Siegfried Hans Boehm
• Anna Bogart, LPC
• Teresa Lynn Boggs, M.S., CCC-SLP
• Mikayla L. Bogulski
• Cydney Boldt, DO
• Olivia Cathryn Boles, DPT
• Savannah R Boles, RT(R)(MR)RN
• Richard Alexander Boleyn, D.C.

• Clinical Social Worker in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.