Individual provider

Charlesetta Willis, MHA, MS, RN

Mental Health Counselor Registered Nurse

Charlesetta Willis, MHA, MS, RN is a Mental Health Counselor in Martinez, GA, registered under NPI 1104575646. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 4145 COLUMBIA RD, Martinez, GA 30907. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

4145 COLUMBIA RD, Martinez, GA 30907 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
RN219487 GA Registered Nurse

This provider holds licence RN219487 issued in GA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)

This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.

What Mental Health covers

Definition to come... NUCC Health Care Provider Taxonomy, code 101YM0800X
Behavioral Health & Social Service Providers Counselor Mental Health

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
101YM0800X Mental Health Counselor Mental Health primary
163W00000X Registered Nurse RN219487 GA

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1104575646 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateMar 22, 2022
Last updatedOct 13, 2022
StatusActive
Sole proprietorNo
CredentialMHA, MS, RN
Practice address 4145 COLUMBIA RD
Martinez, GA 30907
(706) 869-7373
Mailing address 860 WILLOW LK
Evans, GA 30809
The last update on file is Oct 13, 2022. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1104575646 passes the NPI check digit test The final digit 6 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 0 4 5 7 5 6 4
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 0 4 1 7 1 6 8

Sum = 54 · next multiple of 10 = 60 · check digit = 6 · actual last digit = 6

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1104575646?
NPI 1104575646 is the National Provider Identifier assigned to Charlesetta Willis, MHA, MS, RN in Martinez, GA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Mental Health cover?
Definition to come...
How do I contact Charlesetta Willis, MHA, MS, RN?
The phone number on file with NPPES is (706) 869-7373, last updated Oct 13, 2022. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Is NPI 1104575646 a valid number?
Yes. 1104575646 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.