MEDICARE: ALEXANDRA CHARLES M.ED.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1427990076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA CHARLES M.ED.

Provider Business Mailing Address
First Line	:	157 MAIN ST
Second Line	:
City	:	BROCKTON
State	:	MA
Zip	:	02301-4012
Country	:	US
Telephone Number	:	781-344-0102
Fax Number	:	781-344-1635

Provider Business Practice Location Address
First Line	:	157 MAIN ST
Second Line	:
City	:	BROCKTON
State	:	MA
Zip	:	02301-4012
Country	:	US
Telephone Number	:	781-344-0102
Fax Number	:	781-344-1635

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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