Charlene White Bynum, DOCTORAL STUDENT HCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

5464TLF-1 Issued in NV

Practice address

1213 Balzar Ave
Las Vegas, NV 89106-2207

Phone

(702) 810-4830

Fax

(702) 255-7766

NPI assigned

Jan 10, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Covenant of Love Uul Corporation

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1669776092
  NPD (past) Authorized official

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1558665208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 ELDORADO HILLS CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891105646",
            "telephone_number": "702-810-4830",
            "fax_number": "702-255-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 BALZAR AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062207",
            "telephone_number": "702-810-4830",
            "fax_number": "702-255-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYNUM",
        "first_name": "CHARLENE",
        "middle_name": "WHITE",
        "credential": "DOCTORAL STUDENT HCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "5464TLF-1",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "5061AGC-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251S0000X",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Byers
• Victor Vincent Riolo Byers
• Stella Byington
• Sadie L Bylund
• Cashsha Bynum
• Iredila Timagos Bynum, APRN FNP-C
• Mikaila Bynum
• Tierra Bynum
• Laura Anne Byous, PT, DPT
• Anthony Byrd

• Addiction (Substance Use Disorder) Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Addiction (Substance Use Disorder) Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.