Andrea L Charles, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60737830 Issued in WA

Practice address

920 6TH St
Clarkston, WA 99403-2079

Phone

(509) 254-5053

Fax

(509) 769-3500

NPI assigned

Jun 29, 2013

Last updated

Jun 14, 2023By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Dragonfly Counseling PLLC

  • Clinical Social Worker
  • Clarkston, WA
  • NPI 1730607854
  Medicare reassignment NPD Authorized official
• Community Health Association of Spokane

  dba Lewis and Clark Health Center

  • Federally Qualified Health Center (FQHC)
  • Lewiston, ID
  • NPI 1235372707
  Medicare reassignment NPD
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1679363592
  NPD

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

{
    "created_epoch": "1372464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1730529165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2031",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994034031",
            "telephone_number": "509-254-5053",
            "fax_number": "509-769-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 6TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032079",
            "telephone_number": "509-254-5053",
            "fax_number": "509-769-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20006 Cedar Valley Rd Ste 113",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980366478",
            "country_code": "US",
            "telephone_number": "509-254-5053",
            "fax_number": "509-769-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "ANDREA",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-29",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW35066",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60737830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LCSW - 35066",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LW60737830",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carpenter Health PLLC
• Todd M Carpenter, NP
• Jared L Cattron, DMD
• Carol Chandler, NP
• Charles C Dwyer DC PC
• Chastains Inc (Owl Tri-State Pharmacy)
• Elina Chernyak, DO
• Donald Kenneth Chin, MD
• Daniel Christianson
• Brian Francis Ciezki, ACNP

• Clinical Social Worker in Clarkston, WA
• Providers in Clarkston, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.