Jennifer John Charley, LADAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0119271 Issued in NM

Practice address

15 Behavioral Health Rd
Pinehill, NM 87357

Phone

(505) 775-3353

Fax

(505) 775-3630

NPI assigned

Apr 11, 2016

Last updated

Apr 11, 2016By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1659735140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "PINEHILL",
            "state": "NM",
            "postal_code": "873570490",
            "telephone_number": "505-775-3353",
            "fax_number": "505-775-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BEHAVIORAL HEALTH RD",
            "city": "PINEHILL",
            "state": "NM",
            "postal_code": "87357",
            "telephone_number": "505-775-3353",
            "fax_number": "505-775-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLEY",
        "first_name": "JENNIFER",
        "middle_name": "JOHN",
        "name_prefix": "Mrs.",
        "credential": "LADAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0119271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearl A Alonzo, RN
• Gracie Apachito
• Arlene Leola Blanton, R.N.
• Tamarah Lynn Boysel, PHARM.D.
• William Lloyd Cloud Jr., D.D.S.
• Triston Shane Eriacho, LSAA
• Aislinn B Grover
• Perry D Guthrie Jr., FNP-C
• Thomas Earl Himelick, PA-C, MMSC

• Addiction (Substance Use Disorder) Counselor in Pine Hill, NM
• Providers in Pine Hill, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.