Charles Anthony McPhail Sr., PHD, LCSW

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301009130 Issued in MI

Practice address

3151 Airway Ave Ste T2
Costa Mesa, CA 92626-4627

Phone

(310) 422-6744

NPI assigned

Sep 11, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1952137358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE T2",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264627",
            "telephone_number": "310-422-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE T2",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264627",
            "telephone_number": "310-422-6744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41510 Cypress Way",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483771568",
            "country_code": "US",
            "telephone_number": "310-422-6744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCPHAIL",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "name_suffix": "Sr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801034018",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301009130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert McLeod
• Reed McMillan
• Brian McNamara
• David L McNeil, ATC
• Susanna McPeak, NP
• Christina Lynne McReynolds, BCBA
• MD24 la, Inc.
• MD24 San Diego, Inc.
• Me Pivot Holdings LLC
• Bradley Meacham

• Clinical Psychologist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.