Individual provider Active NPI

Charis Rosales, MSW, LICSW, MHP

  • Social Worker
  • Vancouver, WA
National Provider Identifier
1053544262
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LW61220318 Issued in WA
Practice address
10604 NE Highway 99
Vancouver, WA 98686-5613
Phone
(360) 644-1631
NPI assigned
Sep 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Social Worker 104100000X LW61220318 WA Primary

Addresses

Primary practice location

10604 NE Highway 99
Vancouver, WA 98686-5613

Mailing address

10604 NE Highway 99
Vancouver, WA 98686-5613
Phone (360) 644-1631

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
LW61220318WAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1053544262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10604 NE HIGHWAY 99",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986865613",
            "telephone_number": "360-644-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10604 NE HIGHWAY 99",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986865613",
            "telephone_number": "360-644-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSALES",
        "first_name": "CHARIS",
        "credential": "MSW, LICSW, MHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW61220318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.