Individual provider Active NPI

Charlie White, LMHC

  • Mental Health Counselor
  • Cedar Rapids, IA
National Provider Identifier
1114490331
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
087660 Issued in IA
Practice address
2720 1St Ave NE Ste 300
Cedar Rapids, IA 52402-4832
Phone
(319) 200-5104
Fax
(319) 200-2516
NPI assigned
Jan 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 087660 IA Primary

Addresses

Primary practice location

2720 1St Ave NE Ste 300
Cedar Rapids, IA 52402-4832

Mailing address

2720 1St Ave NE Ste 300
Cedar Rapids, IA 52402-4832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2720 1St Ave NE
Cedar Rapids, IA 52402-4832

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
087660IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Family Solutions, LLC CurrentSince Aug 25, 2025 Accepting new patients
Horizons, a Family Service Alliance Past Accepting new patients
Horizons, a Family Service Alliance PastSince Jul 1, 2005 Accepting new patients

Locations

2720 1st Ave NE
Ste 300
Cedar Rapids, IA 52402
Phone (319) 200-5104

1655 Blairs Ferry Rd
Marion, IA 52302
Phone (319) 261-2292

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1114490331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 1ST AVE NE STE 300",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524024832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 1ST AVE NE STE 300",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524024832",
            "telephone_number": "319-200-5104",
            "fax_number": "319-200-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CHARLIE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-10",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "087660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.