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General NPI Number Information
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NPI Number | 1194281691
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Entity Type | Individual
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Provider Name | MOHANNE CHARLES LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 21337 39TH AVE STE 308
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City | BAYSIDE
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State | NY
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Zip | 11361-2071
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Country | US
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Telephone | 917-599-3533
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Fax | 718-691-4968
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Provider Business Mailing Address
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Address Line | 21337 39TH AVE STE 308
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City | BAYSIDE
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State | NY
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Zip | 11361-2071
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Country | US
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Telephone | 917-599-3533
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Fax | 718-691-4968
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 087781
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License Number State | NY
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