Charity June Anderson, CPS

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

License

CPS-20838 Issued in NC

Practice address

312 Clay Brook Dr
Goldsboro, NC 27530-5532

Phone

(405) 657-8627

NPI assigned

Aug 6, 2018

Last updated

Dec 4, 2023By the provider in NPPES

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

Other identifiers 1

Other names 1

• Charity Syrus Former name

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": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1144708603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 76112",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809706112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 CLAY BROOK DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275305532",
            "telephone_number": "405-657-8627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHARITY",
        "middle_name": "JUNE",
        "credential": "CPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "NC",
            "license": "CPS-20838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA ADDICTIONS SPECIALIST PROFESSIONAL PRACTICE BOARD",
            "identifier": "CPS-20838",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARITY",
            "last_name": "SYRUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Abigail Swain Anderson, MSW, LCSW, LCAS, CSI
• Julia D Anderson
• Kelley Anderson
• Krisan Anderson
• Nicholas Kent Anderson, PHARM.D.
• Anesthesia Services Associates

• Prevention Professional in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Prevention Professional in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.