Active NPI
Judith Mangan Charles, LPC
- Counselor
- Woodbury, CT
National Provider Identifier
1508035528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 000018
- Practice address
- 44 Westside Rd
Woodbury, CT 06798-2703 - Phone
- (203) 263-2919
- Fax
- (203) 263-7612
- NPI assigned
- Feb 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 000018 | CT | Primary |
Addresses
Primary practice location
44 Westside Rd
Woodbury, CT 06798-2703
Mailing address
44 Westside Rd
Woodbury, CT 06798-2703
Phone (203) 263-2919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000018 | CT | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203811200000",
"number": "1508035528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 WESTSIDE RD",
"city": "WOODBURY",
"state": "CT",
"postal_code": "067982703",
"telephone_number": "203-263-2919",
"fax_number": "203-263-7612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 WESTSIDE RD",
"city": "WOODBURY",
"state": "CT",
"postal_code": "067982703",
"telephone_number": "203-263-2919",
"fax_number": "203-263-7612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "JUDITH",
"middle_name": "MANGAN",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-24",
"last_updated": "2008-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CT",
"license": "000018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.