Individual provider Active NPI

Nora Elizabeth Charles, PHD

  • Psychologist
  • Hattiesburg, MS
National Provider Identifier
1669784757
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
571007 Issued in MS
Practice address
118 College Drive Box #5025
Hattiesburg, MS 39406-0001
Phone
(601) 266-4330
NPI assigned
Jul 6, 2010
Last updated
Aug 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 571007 MS Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 571007 MS
Clinical Psychologist 103TC0700X 571007 MS
Clinical Child & Adolescent Psychologist 103TC2200X 571007 MS

Addresses

Primary practice location

118 College Drive Box #5025
Hattiesburg, MS 39406-0001

Mailing address

118 College Drive Box #5025
Hattiesburg, MS 39406-0001
Phone (601) 266-4330

Other practice location 1

239 Golden Hill Ln
Kingston, NY 12401-6441
Phone (845) 340-4032

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
571007MSMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Miss Autism Research Team (Smart) Clinic Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1669784757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 COLLEGE DRIVE BOX #5025",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394060001",
            "telephone_number": "601-266-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 COLLEGE DRIVE BOX #5025",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394060001",
            "telephone_number": "601-266-4330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 Golden Hill Ln",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "NY",
            "postal_code": "124016441",
            "country_code": "US",
            "telephone_number": "845-340-4032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "NORA",
        "middle_name": "ELIZABETH",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-06",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MS",
            "license": "571007",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MS",
            "license": "571007",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "571007",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MS",
            "license": "571007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.