Individual
CHARLES WILLIAM KETCHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-R
Contact information
Practice address
28 FOREST LN, FABER, VA 22938-2328
(845) 758-2220
Mailing address
28 FOREST LN, FABER, VA 22938-2328
(845) 758-2220
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
904011232
VA
1041C0700X
Clinical Social Worker
Primary
R031920
NY
Other
Enumeration date
06/25/2013
Last updated
04/06/2020
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