Jamie Marie Charles
Individual provider Active NPI Mental Health Counselor · Ketchikan, AK
NPI 1366047136 · NPPES record last updated Dec 1, 2020
Key facts
- NPI
- 1366047136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 2514 First Ave
Ketchikan, AK 99901-5804 - Phone
- (907) 225-4664
- Fax
- (907) 885-6613
- NPI assigned
- Dec 1, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resilient Youth & Community (Ryc) | Current |
Accepting new patients | |
| Resilient Youth & Community (Ryc) | Current |
Accepting new patients |
Locations
2514 First Ave
Ketchikan, AK 99901
Phone (907) 202-8684
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/rycalaska/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | AK | Yes |
Addresses
Primary practice location
2514 First Ave
Ketchikan, AK 99901-5804
Mailing address
PO Box 7475
Ketchikan, AK 99901-2475
Phone (907) 225-4664
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1021118 | Medicaid | AK | |
| 1584706 | Medicaid | AK |
Other providers in Ketchikan, AK
- Catholic Community Service
- Catholic Community Service
- Cedar & Spruce Counseling
- Megan Cessnun
- Cecilia Chandler
- Chelsea Youmans, FNP LLC
- Victor Chen
- Kelly M Chick
- Alan L Christensen
- Barry Delano Christensen
All providers in Ketchikan, AK · Mental Health Counselor in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.