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MR. CHARLES EARL ETHERIDGE JR. CDCA
NPI 1245759794
Counselor - Addiction (Substance Use Disorder) in Elyria, OH

Active since September 15, 2017
1131 E BROAD ST, ELYRIA, OH 44035(440) 365-1900 Get Directions Write a Review

NPPES record last updated: September 15, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Charles Earl Etheridge Jr. Cdca NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. CHARLES EARL ETHERIDGE JR. CDCA (NPI 1245759794) is an individual addiction (substance use disorder) provider in Elyria, Ohio, licensed in Ohio (CDCA.164758) and active in the NPI registry since September 2017.

NPPES Registry Identity

NPI1245759794
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. CHARLES EARL ETHERIDGE JR.Credential: CDCA
Location Address1131 E BROAD STElyria, OH 44035-6305
Mailing Address1131 E Broad StElyria, OH 44035-6305
Phone(440) 365-1900
Sole ProprietorNo
Enumeration DateSeptember 15, 2017
✔ NPI 1245759794 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OH · CDCA.164758
1131 E BROAD ST, Elyria, OH 44035
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Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICIA ANN HOMZA
Counselor (Addiction (Substance Use Disorder))
1131 E BROAD ST
ELYRIA, OH 44035
Lorain County (440) 365-1900
ERICA LYNN GEORGE CDCA
Counselor (Addiction (Substance Use Disorder))
1131 E BROAD ST
ELYRIA, OH 44035
Lorain County (440) 365-1900
JOEL AMADOR RODRIGUEZ
Peer Specialist
1131 E BROAD ST
ELYRIA, OH 44035
Lorain County (216) 270-7464
ALAN ROBINSON CDCA
Counselor (Addiction (Substance Use Disorder))
1131 E BROAD ST
ELYRIA, OH 44035
Lorain County (440) 365-1900
JULIE ANN SHEETS
Case Manager/Care Coordinator
1131 E BROAD ST
ELYRIA, OH 44035
Lorain County (440) 365-1900
THERESA MICHELLE MILLER
Case Manager/Care Coordinator
1131 E BROAD ST
ELYRIA, OH 44035
Lorain County (216) 270-7464
JENNIFER R FOSTER CDCA
Counselor (Addiction (Substance Use Disorder))
1131 E BROAD ST
ELYRIA, OH 44035
Lorain County (440) 365-1900
TJWANIA BARNES
Peer Specialist
1131 E BROAD ST
ELYRIA, OH 44035
Lorain County (216) 270-7464

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Etheridge's NPI number?

The NPI number for Charles Etheridge is 1245759794. It was assigned to this individual provider in the NPPES registry on September 15, 2017.

Where is Charles Etheridge located?

Charles Etheridge practices at 1131 E Broad St, Elyria, OH 44035. The listed phone number is (440) 365-1900.

What is Charles Etheridge's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Charles Etheridge was last updated on September 15, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.