Provider Demographics
NPI:1477890788
Name:CHARITY, JAMIE BRUNTON (MSED, LPCC-S)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:BRUNTON
Last Name:CHARITY
Suffix:
Gender:F
Credentials:MSED, LPCC-S
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:L
Other - Last Name:BRUNTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED, LPCC
Mailing Address - Street 1:116 GRANVILLE ST STE 105
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3044
Mailing Address - Country:US
Mailing Address - Phone:740-525-5734
Mailing Address - Fax:
Practice Address - Street 1:116 GRANVILLE ST STE 105
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3044
Practice Address - Country:US
Practice Address - Phone:740-525-5734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1100084-SUPV101YP2500X
OHC 1100084101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional