Individual
JENNIFER ELIZABETH CHARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
PO BOX 457, GANADO, AZ 86505-0457
(928) 755-4586
(928) 755-4747
Mailing address
PO BOX 457, GANADO, AZ 86505-0457
(928) 755-4586
(928) 755-4747
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-LAC-LIC-62407
MT
1041C0700X
Clinical Social Worker
BBH-LCSW-LIC-50538
MT
1041C0700X
Clinical Social Worker
I.2103325
—
1041C0700X
Clinical Social Worker
Primary
LCSW-22076
AZ
1041C0700X
Clinical Social Worker
SWB-2024-0096
NM
Other
Enumeration date
08/17/2017
Last updated
06/11/2025
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