Charles W Wickham, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801086180 Issued in MI

Practice address

2342 Parkwood Ave
Ann Arbor, MI 48104

Phone

(734) 218-0546

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1376689364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 PARKWOOD AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045110",
            "telephone_number": "734-218-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2342 PARKWOOD AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-218-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKHAM",
        "first_name": "CHARLES",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801086180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Michelle Wiard, OTR
• Max S Wicha, MD
• Susan Wichhart, PT
• Hannah Lamberg Wick, MD
• Donna M Wicker, OD
• Larysa Tarashevska Wickman, M.D
• Tiffiny S Wicks, NP
• Elizabeth Widmer, M.S. OTR/L
• Baylee Autumn Wiechecki, MD
• Kevin George Wieczerza, D.D.S.

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.