Charlotte M Markley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.029397 Issued in IL

Practice address

121 N Main St Ste 205
Bloomington, IL 61701-7619

Phone

(847) 347-5656

NPI assigned

May 29, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 9, 2025 through Jul 9, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Mind to Heart Therapy PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IL
  • NPI 1801781240
  NPD Authorized official

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1659264760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 NICKI DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042519",
            "telephone_number": "847-347-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N MAIN ST STE 205",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017619",
            "telephone_number": "847-347-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKLEY",
        "first_name": "CHARLOTTE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.029397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trisha Dyan Mann, PHD
• Courtney Manning, DPT
• Kristin Elizabeth Manzi, LCSW
• Maple Shade Dental Bloomington LLC
• Gwenn None Marie, BCPP, BCTMB, LMT
• Jacob Daniel Marlow, H.I.D.
• Rebecca Marquart, LPC
• Debra L Marquis, PT
• Kerri Marsh, LCPC
• Jalyn L Marshall

• Clinical Social Worker in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.