NPIMap

Organization Active NPI

Charlie Charlton, Licsw, LLC

  • Clinical Social Worker
  • Cushing, ME
National Provider Identifier
1174230643
Registry record updated Sep 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CHARLIE CHARLTON, LICSW, LLC
Practice address
18 Lovers LN
Cushing, ME 04563-3255
Phone
(207) 975-2349
Fax
(207) 975-2349
NPI assigned
Nov 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2024

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

Authorized official

Name
Ursula Charlie Charlton, LICSWNPI 1437582061
Title
Owner and Provider
Phone
(207) 975-2349

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

18 Lovers LN
Cushing, ME 04563-3255

Mailing address

18 Lovers LN
Cushing, ME 04563-3255
Phone (207) 975-2349

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726358400000",
    "number": "1174230643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 LOVERS LN",
            "city": "CUSHING",
            "state": "ME",
            "postal_code": "045633255",
            "telephone_number": "207-975-2349",
            "fax_number": "207-975-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 LOVERS LN",
            "city": "CUSHING",
            "state": "ME",
            "postal_code": "045633255",
            "telephone_number": "207-975-2349",
            "fax_number": "207-975-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLIE CHARLTON, LICSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2024-09-15",
        "certification_date": "2024-09-15",
        "status": "A",
        "authorized_official_last_name": "CHARLTON",
        "authorized_official_first_name": "URSULA",
        "authorized_official_middle_name": "CHARLIE",
        "authorized_official_title_or_position": "OWNER AND PROVIDER",
        "authorized_official_telephone_number": "207-975-2349",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cushing, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2024; 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.