Charlotte Bowie

Individual provider Active NPI Mental Health Counselor · Dekalb, IL

NPI 1356003016 · NPPES record last updated Oct 11, 2021

Key facts

NPI
1356003016
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
12 Health Services Dr
Dekalb, IL 60115-9637
Phone
(815) 756-4875
NPI assigned
Oct 11, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YM0800X Yes

Addresses

Primary practice location

12 Health Services Dr
Dekalb, IL 60115-9637

Mailing address

PO Box 1109
Dekalb, IL 60115-7109

Other providers in Dekalb, IL

All providers in Dekalb, IL · Mental Health Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.