Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles Southerly

Individual provider Community Health Worker · NPI 1275209488

Charles Southerly is a Community Health Worker in Paw Paw, West Virginia. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021
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Practice location Address checks out

1165 Pin Oak Rd
Paw Paw, WV 25434-3252
Phone: (304) 822-0390
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Health Worker (primary) Taxonomy 172V00000X

Record details

NPI number1275209488
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 18, 2021
Last updated in NPPESAugust 18, 2021
Certification dateAugust 18, 2021

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