Charles R Thompson-Shealy, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

087851 Issued in NY

Practice address

260 Kings Mall CT # 251
Kingston, NY 12401-1574

Phone

(646) 362-5194

Fax

(646) 980-4704

NPI assigned

Aug 19, 2013

Last updated

Mar 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1740613322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 KINGS MALL CT # 251",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124011574",
            "telephone_number": "646-362-5194",
            "fax_number": "646-980-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 KINGS MALL CT # 251",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124011574",
            "telephone_number": "646-362-5194",
            "fax_number": "646-980-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON-SHEALY",
        "first_name": "CHARLES",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": "0",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Kingston Hospital
• The Satus Group LLC (M & M Prosthetic Associates)
• The Vascular Group PLLC
• Claudwardyne Alexis Thevenin, D.O
• Thomas F Cingel DDS PC
• Shelby Nicole Thompson
• Sarah Thorn
• Melissa Mary Thorna
• Jennifer Thornell, RPA-C
• Tracey G Toback, DPM

• Clinical Social Worker in Kingston, NY
• Providers in Kingston, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.