Charles, Elizabeth Rose

Charles, Elizabeth Rose is an sole proprietor health care provider with primary practice located at 9910 Guidy Ln , Pensacola FL 32514-1670. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Charles, Elizabeth Rose can be contacted via phone (850) 462-1611.

Contact Information

Primary practice address
9910 Guidy Ln Pensacola FL 32514-1670
Phone: (850) 462-1611
Fax: (850) 462-1612
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH12182 Florida
Behavioral Health & Social Service Providers / Pastoral 101YP1600X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Massachusetts

Profile Details

NPI number 1295977023
LBN Legal business name Charles, Elizabeth Rose
Credentials LMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 25th, 2009
Last updated Oct 10th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295977023 NPPES
Florida MEDICAID 010365700

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