Sandoval, Charmayne N
Sandoval, Charmayne N is an individual health care provider with primary practice located at 110 E Routt Ave , Pueblo CO 81004-2117. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Sandoval, Charmayne N can be contacted via phone (719) 543-8711.Contact Information
Primary practice address
110 E Routt Ave
Pueblo CO 81004-2117
Phone: (719) 543-8711
Fax: (719) 543-0171
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | CSW.09923811 | Colorado |
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW.09923811 | Colorado |
Profile Details
NPI number | 1215221320 |
---|---|
LBN Legal business name | Sandoval, Charmayne N |
Credentials | Licensed Clinical Social Worker (LCSW) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 6th, 2011 |
Last updated | Jul 20th, 2021 - about 3 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1215221320 | NPPES |
Colorado | MEDICAID | 61502723 |
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