Individual provider Active NPI

Charles A Light, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1174701270
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34001633A Issued in IN
Practice address
8401 Harcourt Rd
Indianapolis, IN 46260-2036
Phone
(317) 338-4600
NPI assigned
Jan 31, 2008
Last updated
Mar 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34001633A IN Primary

Addresses

Primary practice location

8401 Harcourt Rd
Indianapolis, IN 46260-2036

Mailing address

10330 N Meridian St
Suite 201
Indianapolis, IN 46290-1024

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital & Health Care Center, Inc. PastSince Mar 1, 2010 Accepting new patients
St. Vincent Hospital & Health Care Center, Inc. Past Accepting new patients
Indiana Geriatric Associates, P.C. Clinical PastSince Apr 1, 2002 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1174701270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 N MERIDIAN ST",
            "address_2": "SUITE 201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 HARCOURT RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602036",
            "telephone_number": "317-338-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001633A",
            "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 Mar 18, 2008; 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.