Charlene Jeanette Adams, LICDCCS
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Sandusky, OH
NPI 1043740079 · NPPES record last updated Jun 13, 2017
Key facts
- NPI
- 1043740079
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 964492 (OH)
- Practice address
- 1518 Pearl Street
Sandusky, OH 44870 - Phone
- (419) 515-0663
- NPI assigned
- Jun 13, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 964492 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| 100761 | OH | MD | Pastoral Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 100761 | OH | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 964492 | OH | Yes |
Addresses
Primary practice location
1518 Pearl Street
Sandusky, OH 44870
Mailing address
1518 Pearl St
Sandusky, OH 44870-3038
Other providers in Sandusky, OH
- Renee Nicole Aaron
- Abilities Pediatric Therapy LLC
- Ability Works, Inc
- Academy of Arts and Sciences
- Timothy James Adamowicz II
- Patrice Adcock
- Genevra Addis
- Candace Adelman
- Jessica Susan Adkins
- Advanced Health
All providers in Sandusky, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.