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General NPI Number Information
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NPI Number | 1114870433
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Entity Type | Individual
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Provider Name | ALIAS JAMES CHARLEY LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | U.S. 191 & HOSPITAL DRIVE
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City | CHINLE
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State | AZ
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Zip | 86503-3805
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Country | US
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Telephone | 928-674-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3805
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City | CHINLE
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State | AZ
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Zip | 86503-3805
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | M-07746
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SWB-2025-0575
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License Number State | NM
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