Provider Demographics
NPI:1477376366
Name:SEARCY, CHARLES (CASAC -M, MHS,)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:SEARCY
Suffix:
Gender:M
Credentials:CASAC -M, MHS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 ST. NICHOLAS AVENUE
Mailing Address - Street 2:5-D
Mailing Address - City:MANHATTAN
Mailing Address - State:NY
Mailing Address - Zip Code:10027
Mailing Address - Country:US
Mailing Address - Phone:917-386-1422
Mailing Address - Fax:
Practice Address - Street 1:119 WEST 124TH STREET
Practice Address - Street 2:
Practice Address - City:NEW
Practice Address - State:NY
Practice Address - Zip Code:10027
Practice Address - Country:US
Practice Address - Phone:212-932-2676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11072024778323101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)