Rebecca Lynne Charles, LLMSW

Individual provider Active NPI Clinical Social Worker · Stanton, MI

NPI 1356983407 · NPPES record last updated Oct 10, 2019

Key facts

NPI
1356983407
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801105799 (MI)
Practice address
611 N State St
Stanton, MI 48888-9702
Phone
(989) 831-7520
Fax
(989) 831-7578
NPI assigned
Oct 10, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6801105799MIMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801105799 MI Yes

Addresses

Primary practice location

611 N State St
Stanton, MI 48888-9702

Mailing address

611 N State St
Stanton, MI 48888-9702
Phone (989) 831-7520

Other providers in Stanton, MI

All providers in Stanton, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.