Charles Waltz Dowdy V, CRC, LCPC, AACC
Individual provider Active NPI Professional Counselor · Zion, IL
NPI 1861711228 · NPPES record last updated May 25, 2010
Key facts
- NPI
- 1861711228
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- Practice address
- 2018 Dawn LN
Zion, IL 60099-5108 - Phone
- (847) 731-3192
- NPI assigned
- May 25, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Love-Light Christian Counseling, NFP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Yes |
Addresses
Primary practice location
2018 Dawn LN
Zion, IL 60099-5108
Mailing address
2018 Dawn LN
Zion, IL 60099-5108
Phone (847) 731-3192
Other providers in Zion, IL
- Elisa A Demet
- Lisa Albino Dennis
- Jose Marie Cornelio Derla
- Leah Derla
- Monica Donald
- Neil Curtis Dunavin
- Wallis Olivia Edwards
- Julie K. Elliott
- Ryan H. Engel
- Austin James Engquist
All providers in Zion, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.