Charlie Stanford Jr., MS, LMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60699756 Issued in WA

Practice address

1106 Columbia Ave Ste 151
Marysville, WA 98270-4347

Phone

(253) 269-0224

Fax

(253) 833-8850

NPI assigned

Jun 7, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496793600000",
    "number": "1770012320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 COLUMBIA AVE STE 151",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704347",
            "telephone_number": "253-269-0224",
            "fax_number": "360-386-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 COLUMBIA AVE STE 151",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704347",
            "telephone_number": "253-269-0224",
            "fax_number": "253-833-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "CHARLIE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MS, LMHCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2017-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60699756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Marysville, WA
• Providers in Marysville, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; 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.