MEDICARE: CHARLOTTE F. ST. JUSTE LCSW

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	1041C0700X	Clinical Social Worker	084492	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	086201M	OTHER	VA	SENTARA
2	178274	OTHER	VA	ANTHEM BLUE CROSS BLUE SHIELD
3	353677	OTHER	VA	MHN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235151762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE F. ST. JUSTE LCSW

Provider Business Mailing Address
First Line	:	54 CONTINENTAL PL
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10303-2221
Country	:	US
Telephone Number	:	646-306-7213
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 CONTINENTAL PL
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10303-2221
Country	:	US
Telephone Number	:	646-306-7213
Fax Number	:

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/18/2017

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