Individual provider Active NPI

Charmelle Garrett, LICSW

  • Clinical Social Worker
  • Birmingham, AL
National Provider Identifier
1053031005
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4220C Issued in AL
Practice address
2612 Streetman Cir
Birmingham, AL 35235-2132
Phone
(205) 789-1069
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4220C AL Primary

Addresses

Primary practice location

2612 Streetman Cir
Birmingham, AL 35235-2132

Mailing address

2612 Streetman Cir
Birmingham, AL 35235-2132
Phone (205) 789-1069

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
4220CALMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1053031005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 STREETMAN CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352352132",
            "telephone_number": "205-789-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 STREETMAN CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352352132",
            "telephone_number": "205-789-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "CHARMELLE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4220C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.