Victoria Charleston, LCAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

87001015A Issued in IN

Practice address

1110 W 5TH Ave
Gary, IN 46402-1723

Phone

(219) 885-4264

Fax

(219) 239-2944

NPI assigned

Jun 5, 2014

Last updated

Jun 5, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mind Body and Soul a Road to Recovery

  • Addiction (Substance Use Disorder) Counselor
  • Merrillville, IN
  • NPI 1366018129
  NPD (past)
• Southlake Community Mental Health Center Inc.

  dba Regional Mental Health Center

  • Psychiatric Hospital
  • Merrillville, IN
  • NPI 1548407216
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1366855462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5077 ADAMS ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464084628",
            "telephone_number": "219-887-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W 5TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021723",
            "telephone_number": "219-885-4264",
            "fax_number": "219-239-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLESTON",
        "first_name": "VICTORIA",
        "credential": "LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001015A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathew V Castelino, MD
• Catholic Charities Diocese of Gary Inc
• Catholic Charities Diocese of Gary Inc
• Cep America LLC
• Demia Chandler, MENTAL HEALTH TECH
• Charter School of the Dunes
• Charter School of the Dunes
• Karla Chase
• Marsha Chico
• Leelarani Chigurupati, RD

• Addiction (Substance Use Disorder) Counselor in Gary, IN
• Providers in Gary, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.