Charles Avery, LICSW

Individual provider Active NPI Clinical Social Worker · Washington, DC

NPI 1174764427 · NPPES record last updated Mar 17, 2009

Key facts

NPI
1174764427
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LC300357 (DC)
Practice address
2570 Sherman Ave NW
Washington, DC 20001-2299
Phone
(202) 232-6100
NPI assigned
Mar 17, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC300357 DC Yes

Addresses

Primary practice location

2570 Sherman Ave NW
Washington, DC 20001-2299

Mailing address

46899 Antioch PL
Sterling, VA 20164-8651

Other providers in Washington, DC

All providers in Washington, DC · Clinical Social Worker in District of Columbia

Sources for this page

Verify at the official NPI Registry.