Individual provider Active NPI

Charity Laister, LICSW

  • Clinical Social Worker
  • Centreville, AL
National Provider Identifier
1194296343
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3779C Issued in AL
Practice address
405 Belcher St
Centreville, AL 35042-2946
Phone
(205) 926-2992
Fax
(205) 316-7675
NPI assigned
Dec 16, 2018
Last updated
Dec 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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 3779C AL Primary

Addresses

Primary practice location

405 Belcher St
Centreville, AL 35042-2946

Mailing address

405 Belcher St
Centreville, AL 35042-2946
Phone (205) 926-2992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20190128000862 AL Practitioner - Clinical Social Worker 3173860228 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3779CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cahaba Medical Care Foundation CurrentSince Dec 12, 2018 Accepting new patients
Cahaba Medical Care Foundation CurrentSince Dec 12, 2018 Accepting new patients

Locations

1308 Tuscaloosa Ave SW
Birmingham, AL 35211
Phone (205) 679-6325

195 Hospital Dr
Centreville, AL 35042
Phone (205) 225-7455

405 Belcher St
Centreville, AL 35042
Phone (205) 926-4694

Organizations & group practices 2

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": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1194296343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BELCHER ST",
            "city": "CENTREVILLE",
            "state": "AL",
            "postal_code": "350422946",
            "telephone_number": "205-926-2992",
            "fax_number": "205-316-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BELCHER ST",
            "city": "CENTREVILLE",
            "state": "AL",
            "postal_code": "350422946",
            "telephone_number": "205-926-2992",
            "fax_number": "205-316-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAISTER",
        "first_name": "CHARITY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3779C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, AL

Sources for this page

Verify at the official NPI Registry.