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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 4 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1215221320 NPPES
Colorado MEDICAID 61502723

Popular Providers