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Individual

MS. MICHELLE MARIE CHARLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP,LCSW; RN

Contact information

Practice address
180 FORT WASHINGTON AVE FL 6, NEW YORK, NY 10032-3722
(212) 305-3174
Mailing address
224 W 124TH ST APT 1108, NEW YORK, NY 10027-4938
(917) 517-9286

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
095645-1
NY
1041C0700X
Clinical Social Worker
087700-1
NY
163W00000X
Registered Nurse
827298
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404955
NY

Other

Enumeration date
08/19/2015
Last updated
09/03/2024
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