Provider Demographics
NPI:1881858207
Name:FINKLEY, CHARLIE EARL (AT)
Entity type:Individual
Prefix:
First Name:CHARLIE
Middle Name:EARL
Last Name:FINKLEY
Suffix:
Gender:M
Credentials:AT
Other - Prefix:MR
Other - First Name:CHARLIE
Other - Middle Name:EARL
Other - Last Name:FINKLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AT
Mailing Address - Street 1:2231 POPPS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-4114
Mailing Address - Country:US
Mailing Address - Phone:228-523-4773
Mailing Address - Fax:228-523-5955
Practice Address - Street 1:2231 POPPS FERRY RD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-4114
Practice Address - Country:US
Practice Address - Phone:228-523-4773
Practice Address - Fax:228-523-5955
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MSW3165101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor