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

Mr. Charles Earl Etheridge Jr., CDCA

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1245759794

Mr. Charles Earl Etheridge Jr., CDCA is an Addiction (Substance Use Disorder) Counselor in Elyria, Ohio. Licensed in Ohio. Registered with an NPI since 2017.

Licensed in
OH
In the registry since
2017

Practice location Address checks out

1131 E Broad St
Elyria, OH 44035-6305
Phone: (440) 365-1900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CDCA.164758 (OH)

Record details

NPI number1245759794
Entity typeIndividual (Type 1)
GenderMale
Credentials CDCA
Sole proprietorNo
NPI enumeratedSeptember 15, 2017
Last updated in NPPESSeptember 15, 2017

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