Look up the most recent NPI and PECOS records

Andre Charley

Social Worker

Behavioral Health & Social Service Providers

22511 Telegraph Rd, Southfield, MI 48033-4115

PECOS Enrollment

Based on the most recent information from CMS, provider Andre Charley is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:21 AM.

Profile Details

Provider ID
1942570817
Provider Type
Individual
Full Name
Charley, Andre
Credential
LMSW

Gender
Male
Sole Proprietor
No
Enumeration Date
1/9/2012
Last Updated
12/24/2021

Contact Information

Practice Location

22511 Telegraph Rd, Southfield, MI 48033-4115

(313) 587-9869

(313) 209-8989

Mailing Location

20726 Westover Ave, Southfield, MI 48075-5621

(313) 587-9869

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 6801085944 Michigan
Code 172V00000X	Description Community Health Worker Other Service Providers	License 6801085944 Michigan

Andre Charley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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Description

License

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