Charlisa Feliesh Addison, ADT TRAINEE – Counselor

Key facts

NPI: 1679482392
Entity type: Individual (NPI type 1)
Primary specialty: Counselor 101Y00000X
License: 4143 (MD)
Practice address: 1308 Business Center Way Ste 102
Edgewood, MD 21040-1504
Phone: (667) 777-1231
NPI assigned: Sep 7, 2026
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X	4143	MD	Yes

Addresses

Primary practice location

1308 Business Center Way Ste 102
Edgewood, MD 21040-1504

Mailing address

1315 Gold Meadow Way Apt 101
Edgewood, MD 21040-1523
Phone (667) 777-1231

Other names

Charlisa Addison Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 7, 2026.

{
    "created_epoch": "1788739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1679482392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 GOLD MEADOW WAY APT 101",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401523",
            "telephone_number": "667-777-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 BUSINESS CENTER WAY STE 102",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401504",
            "telephone_number": "667-777-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDISON",
        "first_name": "CHARLISA",
        "middle_name": "FELIESH",
        "credential": "ADT TRAINEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-07",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "4143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLISA",
            "last_name": "ADDISON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edgewood, MD

All providers in Edgewood, MD · Counselor in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.

Verify at the official NPI Registry.