Charlie Vincent Dawley, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP1394 Issued in MN

Practice address

205 7TH Ave SW
Stewartville, MN 55976-1127

Phone

(507) 254-2180

NPI assigned

Aug 12, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Riverside Psychological Services

  • Community/Behavioral Health Agency
  • Rochester, MN
  • NPI 1184856338
  NPD (past)

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1447406293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 382",
            "city": "STEWARTVILLE",
            "state": "MN",
            "postal_code": "559760382",
            "telephone_number": "507-254-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 7TH AVE SW",
            "city": "STEWARTVILLE",
            "state": "MN",
            "postal_code": "559761127",
            "telephone_number": "507-254-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWLEY",
        "first_name": "CHARLIE",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adventure Optical Inc.
• WM Bardwell
• Thomas William Bro, DDS
• Justin Alan Cyphers, D.C.
• Caroline Dahlke
• Judith A Devorak
• Krista Freed
• Garden Cottage Assisted Living Inc.
• Ashley Marie Hanson, MS
• Michelle L Higgins, APRN, CNP

• Psychologist in Stewartville, MN
• Providers in Stewartville, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.