Charles Edward Hubert Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C013879 Issued in NC

Practice address

159 Sailway Rd
Winston Salem, NC 27127-8906

Phone

(336) 281-5005

NPI assigned

Jul 23, 2017

Last updated

Jul 12, 2021By the provider in NPPES

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

Enrolled in NC

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.

Enrollment records 1

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.

• Tides Counseling and Wellness, PLLC

  • Clinical Social Worker
  • High Point, NC
  • NPI 1790357622
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1821511759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 SAILWAY RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271278906",
            "telephone_number": "336-995-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 SAILWAY RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271278906",
            "telephone_number": "336-281-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBERT",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-23",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Huang, MD
• Rachel Huang
• Ambriana Simone Hubbard, PHARMD
• John B. Hubbard, M.D.
• Katherine R Hubbard
• Christa Holland Hubert, PA-C
• Amber Oakes Hudgins, PHARMD, CSP, CPP
• Anna Lisa Hudson, MD
• Jon Edward Hudson, M.D.
• Shelby Layne Hudson, CPP, PHARMD

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.