Provider Demographics
NPI:1477718575
Name:HUMPHREY, CHARITY M J (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CHARITY
Middle Name:M J
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:CHARITY
Other - Middle Name:M J
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:6940 RARITAN DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46221-4886
Mailing Address - Country:US
Mailing Address - Phone:317-821-0849
Mailing Address - Fax:
Practice Address - Street 1:86 DRAKE RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-2763
Practice Address - Country:US
Practice Address - Phone:317-736-0014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health