Active NPI
Charlene Marie Smith
- Addiction (Substance Use Disorder) Counselor
- Camas, WA
National Provider Identifier
1649988841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- T-22-2106
- Practice address
- 2816 NW 37TH Ave
Camas, WA 98607-8203 - Phone
- (949) 572-0598
- NPI assigned
- Nov 7, 2022
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | T-22-2106 | OR | Primary |
Addresses
Primary practice location
2816 NW 37TH Ave
Camas, WA 98607-8203
Mailing address
2816 NW 37TH Ave
Camas, WA 98607-8203
Phone (949) 572-0598
Other names 1
- Charlene M Loose
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | charlenes@oregonchangeclinic.com | Direct | |
| Direct Messaging Address | charlenes@oregonchangeclinic.com | Direct |
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 |
|---|---|---|---|
| T-22-2106 | OR | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667779200000",
"number": "1649988841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2816 NW 37TH AVE",
"city": "CAMAS",
"state": "WA",
"postal_code": "986078203",
"telephone_number": "949-572-0598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2816 NW 37TH AVE",
"city": "CAMAS",
"state": "WA",
"postal_code": "986078203",
"telephone_number": "949-572-0598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "CHARLENE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-07",
"last_updated": "2022-11-07",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "T-22-2106",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "charlenes@oregonchangeclinic.com",
"affiliation": "N",
"endpointDescription": "Work Email",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2816 NW 37th Ave",
"city": "Camas",
"state": "WA",
"country_code": "US",
"postal_code": "986078203",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "charlenes@oregonchangeclinic.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2816 NW 37th Ave",
"city": "Camas",
"state": "WA",
"country_code": "US",
"postal_code": "986078203",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "CHARLENE",
"last_name": "LOOSE",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Camas, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.