Charles Pickering, CT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.1700541-TRNE Issued in OH

Practice address

950 Meadow Dr
Mount Gilead, OH 43338-1389

Phone

(419) 949-2000

NPI assigned

Feb 21, 2018

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 OH

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

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast IncGroup PAC ID 8426014853, 48 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Southeast, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1932169497
  Medicare reassignment Care Compare group NPD
• Southeast, Inc

  • Federally Qualified Health Center (FQHC)
  • Mount Gilead, OH
  • NPI 1114893203
  NPD
• Southeast, Inc

  • Community/Behavioral Health Agency
  • Columbus, OH
  • NPI 1366703084
  NPD (past)

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1902307432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 BEARD RD",
            "city": "SUNBURY",
            "state": "OH",
            "postal_code": "430748998",
            "telephone_number": "740-816-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 MEADOW DR",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433381389",
            "telephone_number": "419-949-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKERING",
        "first_name": "CHARLES",
        "credential": "CT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1700541-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy C Pentecost, CT
• Susan Elisabeth Perry, R.PH.
• Heather Rose Persinger, LPN
• Shelly R Persinger
• Raven Phelps
• Matthew S. Piper, O.D.
• Kinzie Porter
• Joe Richard Prater, CRNA
• Tara Ellen Price
• Walter Arthur Quillman

• Mental Health Counselor in Mount Gilead, OH
• Providers in Mount Gilead, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.