Provider Demographics
NPI:1386133841
Name:ALBERT, CHARELL (QMHS)
Entity type:Individual
Prefix:
First Name:CHARELL
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 N BRICE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-6510
Mailing Address - Country:US
Mailing Address - Phone:614-367-7700
Mailing Address - Fax:
Practice Address - Street 1:99 N BRICE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-6510
Practice Address - Country:US
Practice Address - Phone:614-367-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator