MEDICARE: MISS CHARITY SADE BEAN DOULA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	174N00000X	Lactation Consultant (Non-RN)
3	374J00000X	Doula

General Provider Information

NPI Number	:	1841863735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CHARITY SADE BEAN DOULA

Provider Business Mailing Address
First Line	:	2 TWIN OAKS DR
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62221-4452
Country	:	US
Telephone Number	:	618-570-3169
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 IOWA AVE STE 211
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62220-3940
Country	:	US
Telephone Number	:	618-570-3169
Fax Number	:

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

Provider Enumeration Date	:	07/20/2021
Last Update Date	:	07/22/2023

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Directions to “ MISS CHARITY SADE BEAN DOULA” Practice Location

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