Charles Oliver, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

150256 Issued in OH

Practice address

411 Court St
Portsmouth, OH 45662-3932

Phone

(740) 354-6685

NPI assigned

Nov 11, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Phoenix Center, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ironton, OH
  • NPI 1225670813

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Shawnee Counseling Center LLC

  • Substance Abuse Rehabilitation Facility
  • Portsmouth, OH
  • NPI 1033695051
  Medicare reassignment NPD
• Shawnee Counseling Center LLC

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1780278705
  NPD
• Phoenix Center, Inc.

  • General Practice Physician
  • Ironton, OH
  • NPI 1366379075
  NPD (past)

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

{
    "created_epoch": "1510358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543017600000",
    "number": "1164935284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 FINDLAY ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 COURT ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623932",
            "telephone_number": "740-354-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "CHARLES",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-11",
        "last_updated": "2018-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "QMHS3",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "150256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ohio CVS Stores LLC
• Ohio CVS Stores LLC
• Ohio Pest Control
• Joseph Ohrstrom
• Travis Older
• Janice M Oliver, MSW LISW ACSW
• Jessica L Oliver, CDCA
• Sara K Oliver
• Takaaki Onodera, MD
• Open Chair Psychiatry & Mental Wellness

• Addiction (Substance Use Disorder) Counselor in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.