Active NPI
Michael Charnstrom
- Clinical Social Worker
- Indianapolis, IN
National Provider Identifier
1073117958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34009017A
- Practice address
- 1030 E County Line Rd Ste C1
Indianapolis, IN 46227-2998 - Phone
- (317) 497-6290
- NPI assigned
- Nov 23, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34009017A | IN | Primary |
Addresses
Primary practice location
1030 E County Line Rd Ste C1
Indianapolis, IN 46227-2998
Mailing address
6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34009017A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Network, Inc. | Past | Accepting new patients | |
| Community Health Network, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Indianapolis, IN
- NPI 1922336262
-
- Psychiatric Hospital Unit
- Indianapolis, IN
- NPI 1679545966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1073117958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6626 E 75TH ST STE 500",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 E COUNTY LINE RD STE C1",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462272998",
"telephone_number": "317-497-6290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARNSTROM",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-23",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34009017A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.