Josie Lynn Charles, TLLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

636200902 Issued in MI

Practice address

8344 Hall Rd Ste 209
Utica, MI 48317-5554

Phone

(586) 286-5870

Fax

(586) 286-5834

NPI assigned

Feb 6, 2024

Last updated

Feb 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1467216994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7159 MELDRUM RD",
            "city": "IRA",
            "state": "MI",
            "postal_code": "480232429",
            "telephone_number": "586-804-1207",
            "fax_number": "586-286-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8344 HALL RD STE 209",
            "city": "UTICA",
            "state": "MI",
            "postal_code": "483175554",
            "telephone_number": "586-286-5870",
            "fax_number": "586-286-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "JOSIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "TLLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "636200902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "636200902",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Utica, MI
• Providers in Utica, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.