| Doctor Name: | MR. JOHN ADRIAN CHARLES |
| NPI Number: | 1790082725 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW, ADC-II |
| License Number: | 081256 |
| Business Practice Address: | 2480 Llewellyn Ave Fort George G Meade, MD - 207557081 |
| Business Phone Number: | 3016778441 |
| Business Fax Number: | 3016778176 |
| Mailing Address: | 2480 Llewellyn Avenue, Kimbrough Ambulatory Care Center FORT GEORGE G. MEADE |
| State: | MD |
| Postal Code: | 207555800 |
| Phone Number: | 3016778441 |
| Fax Number: | 3016778176 |
| NPI Enumeration Date: | 02/28/2011 |
| NPI Last Update Date: | 02/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 081256 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |