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General NPI Number Information
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NPI Number | 1427150630
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Entity Type | Organization
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Legal Business Name | THE CHARLESTON CENTER, INC
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 3040 BERKMAR DR STE A1
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1593
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Country | US
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Telephone | 434-979-8628
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Fax | 434-979-8536
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Provider Business Mailing Address
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Address Line | 3040 BERKMAR DR STE A1
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1593
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Country | US
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Telephone | 434-979-8628
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Fax | 434-979-8536
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. KERRIE LYNN MANTHEY
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Credential | M.S., CCC-SLP
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Telephone | 434-979-8628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | N/A
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License Number State |
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