Provider Demographics
NPI:1619977808
Name:MOST, CHARLES JOHANNES (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JOHANNES
Last Name:MOST
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1978
Mailing Address - Country:US
Mailing Address - Phone:908-859-5450
Mailing Address - Fax:908-859-1285
Practice Address - Street 1:420 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1978
Practice Address - Country:US
Practice Address - Phone:908-859-5450
Practice Address - Fax:908-859-1285
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100217600103TC0700X, 103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ440107Medicare PIN