Charleene Virginia Nicely, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0893 Issued in NC

Practice address

2270 Hendersonville Rd
Ste 1
Arden, NC 28704-2734

Phone

(828) 778-4721

NPI assigned

Feb 19, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Charleene Nicely Gallenberger Former name

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Specialty

Clinical Psychologist

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1780852160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 LANCASTER RD",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "28792",
            "telephone_number": "828-778-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 HENDERSONVILLE RD",
            "address_2": "STE 1",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287042734",
            "telephone_number": "828-778-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICELY",
        "first_name": "CHARLEENE",
        "middle_name": "VIRGINIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "AD003667",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS 1142",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "0893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLEENE",
            "last_name": "GALLENBERGER",
            "middle_name": "NICELY",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tejal Naik, MD
• NCRX
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• Krista Leigh Nelson
• Next Gen Chiropractic Wellness and Performance Center
• Jennifer C Nicolini, M.D.
• Garrett Carl Noid, MA
• Bree Normandin, LCMHC
• North Carolina CVS Pharmacy LLC
• North Carolina CVS Pharmacy, L.L.C.

• Clinical Psychologist in Arden, NC
• Providers in Arden, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.