Active NPI
Jacob W Charles
- Mental Health Counselor
- Reno, NV
National Provider Identifier
1881991842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- GF-125403151
- Practice address
- 411 Mill St
Reno, NV 89502-1025 - Phone
- (775) 351-7057
- NPI assigned
- Feb 27, 2011
- Last updated
- Feb 27, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | GF-125403151 | NV | Primary |
Addresses
Primary practice location
411 Mill St
Reno, NV 89502-1025
Mailing address
710 Hunter Lake Dr
Reno, NV 89509-1216
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GF-125403151 | NV | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298764800000",
"number": "1881991842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 HUNTER LAKE DR",
"city": "RENO",
"state": "NV",
"postal_code": "895091216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 MILL ST",
"city": "RENO",
"state": "NV",
"postal_code": "895021025",
"telephone_number": "775-351-7057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "JACOB",
"middle_name": "W",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-27",
"last_updated": "2011-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "GF-125403151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.