Active NPI
Adrienne Charleston, LPA
- Clinical Psychologist
- Raleigh, NC
National Provider Identifier
1720335417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4299
- Practice address
- 5878 Faringdon PL
Ste 11B
Raleigh, NC 27609-4589 - Phone
- (919) 346-4617
- NPI assigned
- Aug 13, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4299 | NC | |
| Counseling Psychologist | 103TC1900X | 4299 | NC | |
| Clinical Psychologist | 103TC0700X | 4299 | NC | Primary |
Addresses
Primary practice location
5878 Faringdon PL
Ste 11B
Raleigh, NC 27609-4589
Mailing address
PO Box 2372
Garner, NC 27529-2372
Phone (919) 346-4619
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190522001239 | NC | Practitioner - Psychologist Billing Independently | 6406199058 | Practice locations: Raleigh, NC |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5878 Faringdon PL
Suite 11B
Raleigh, NC 27609-4589
Phone (919) 346-4617
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4299 | NC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557100800000",
"number": "1720335417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2372",
"city": "GARNER",
"state": "NC",
"postal_code": "275292372",
"telephone_number": "919-346-4619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5878 FARINGDON PL",
"address_2": "STE 11B",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276094589",
"telephone_number": "919-346-4617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLESTON",
"first_name": "ADRIENNE",
"credential": "LPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-13",
"last_updated": "2019-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "4299",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NC",
"license": "4299",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "4299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.