Provider Demographics
NPI:1871833327
Name:READ, CHARMAINE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:
Last Name:READ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123E 44TH ST A
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:ID
Mailing Address - Zip Code:83714-5008
Mailing Address - Country:US
Mailing Address - Phone:208-921-3197
Mailing Address - Fax:208-658-4827
Practice Address - Street 1:123 E. 44TH ST
Practice Address - Street 2:STE. A
Practice Address - City:GARDEN CITY
Practice Address - State:ID
Practice Address - Zip Code:83714
Practice Address - Country:US
Practice Address - Phone:208-921-3197
Practice Address - Fax:208-658-4827
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-347401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical