1. Home
  2. Directory
  3. New York
  4. Riverhead
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

CHARLES WALTER SOUTHARD
NPI 1346047388
Student in an Organized Health Care Education/Training Program in Riverhead, NY

Active since February 27, 2025
400 W MAIN ST, RIVERHEAD, NY 11901(631) 369-0104 Get Directions Write a Review

NPPES record last updated: February 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Charles Walter Southard NPPES

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

CHARLES WALTER SOUTHARD (NPI 1346047388) is an individual student in an organized health care education/training program in Riverhead, New York and active in the NPI registry since February 2025.

NPPES Registry Identity

NPI1346047388
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameCHARLES WALTER SOUTHARD
Location Address400 W MAIN STRiverhead, NY 11901-2813
Mailing Address18 Forest LnCoram, NY 11727-3139
Phone(631) 369-0104
Sole ProprietorNo
Enumeration DateFebruary 27, 2025
NPPES CertifiedFebruary 27, 2025
✔ NPI 1346047388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
400 W MAIN ST, Riverhead, NY 11901
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

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

DANILLE RAVEN CORNWELL
Peer Specialist
400 W MAIN ST
RIVERHEAD, NY 11901
Suffolk County (631) 833-6581
MARY ELIZABETH KOZAK C.R.P.A.
Peer Specialist
400 W MAIN ST
RIVERHEAD, NY 11901
Suffolk County (631) 369-0104
KEVIN J CARAMORE
Student in an Organized Health Care Education/Training Program
400 W MAIN ST
RIVERHEAD, NY 11901
Suffolk County (631) 369-0104
BRIANNE RAY LMSW
Social Worker
400 W MAIN ST
RIVERHEAD, NY 11901
Suffolk County (631) 369-0104
BRIANNA KNIGHT
Counselor (Addiction (Substance Use Disorder))
400 W MAIN ST
RIVERHEAD, NY 11901
Suffolk County (631) 369-0104
MICHAELA JOANNA HARRIS
Peer Specialist
400 W MAIN ST
RIVERHEAD, NY 11901
Suffolk County (631) 369-0104
MS. ROSEANN LASALA
Peer Specialist
400 W MAIN ST
RIVERHEAD, NY 11901
Suffolk County (631) 682-2929
VALERIE SANKAR
Counselor (Mental Health)
400 W MAIN ST
RIVERHEAD, NY 11901
Suffolk County (631) 508-5007

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 Southard's NPI number?

The NPI number for Charles Southard is 1346047388. It was assigned to this individual provider in the NPPES registry on February 27, 2025.

Where is Charles Southard located?

Charles Southard practices at 400 W Main St, Riverhead, NY 11901. The listed phone number is (631) 369-0104.

What is Charles Southard's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Charles Southard was last updated on February 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.