Charles K. Underwood Jr., PH.D. LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 6777 Issued in FL

Practice address

1047 Shinnecock Hills Dr
Oviedo, FL 32765-5809

Phone

(407) 342-7165

Fax

(407) 977-0931

NPI assigned

Oct 22, 2008

Last updated

Oct 22, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1174775084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825",
            "city": "GOLDENROD",
            "state": "FL",
            "postal_code": "327330825",
            "telephone_number": "407-342-7165",
            "fax_number": "407-977-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1047 SHINNECOCK HILLS DR",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655809",
            "telephone_number": "407-342-7165",
            "fax_number": "407-977-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "CHARLES",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.    LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 6777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z024Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.