Justin Charles, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS017531 Issued in PA

Practice address

1400 Blackhorse Hill Rd BLDG 39
Coatesville, PA 19320-2040

Phone

(610) 384-7711

NPI assigned

Jan 27, 2014

Sex

Male

Sole proprietor

Yes

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)

Enrolled

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1851714943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 N BROAD ST",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175431011",
            "telephone_number": "717-466-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BLACKHORSE HILL RD BLDG 39",
            "city": "COATESVILLE",
            "state": "PA",
            "postal_code": "193202040",
            "telephone_number": "610-384-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-27",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Michael Chambers, PSY.D.
• Terri L Champion
• Martha J. Champlin, CRNP
• Karen Chang, LCSW
• Ferlin Natacha Charles, PSYD, LCSW
• Sheila Chellappa, M.D.
• Chertok'S Furniture
• Chespenn Health Services
• Chester County Anesthesia Assoc
• Chester County Community Dental

• Clinical Psychologist in Coatesville, PA
• Providers in Coatesville, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.