Elvina Jean Charley, ED.S.
Individual provider Active NPI School Psychologist · Ganado, AZ
NPI 1508037219 · NPPES record last updated Mar 20, 2008
Key facts
- NPI
- 1508037219
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- 3704675 (AZ)
- Practice address
- Hwy 264, US 191
Ganado, AZ 86505-1757 - Phone
- (928) 755-1020
- NPI assigned
- Mar 20, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3704675 | AZ | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ganado Unified School District #20 | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 3704675 | AZ | Yes |
Addresses
Primary practice location
Hwy 264, US 191
Ganado, AZ 86505-1757
Mailing address
PO Box 1757
Ganado, AZ 86505-1757
Phone (928) 755-1020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 052607 | Medicaid | AZ |
Other providers in Ganado, AZ
- Kaitlin Amrine
- Patricia Ann Blosser
- Kathy Loy Buchanan
- Takur George Buck
- Lori Michelle Campas
- Jennifer Elizabeth Charley
- Thomas Gary Cole
- Timothy P Cousens Jr.
- Michelle Carmen Dale
- Tyleigh Rain Davidson
All providers in Ganado, AZ · School Psychologist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2008. 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.