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NPI Code Detail

MEDICARE: SALLY CHARNEY

MEDICARE: SALLY CHARNEY
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
1101YA0400XAddiction (Substance Use Disorder) Counselor981397OH
21041C0700XClinical Social Worker327434OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760726848
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY CHARNEY
Provider Business Mailing Address
First Line : 9083 MENTOR AVE
Second Line :
City : MENTOR
State : OH
Zip : 44060-6462
Country : US
Telephone Number : 440-255-0678
Fax Number :
Provider Business Practice Location Address
First Line : 9083 MENTOR AVE
Second Line :
City : MENTOR
State : OH
Zip : 44060-6462
Country : US
Telephone Number : 440-255-0678
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2012
Last Update Date : 03/22/2026

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Directions to “ SALLY CHARNEY ” Practice Location

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