CHARLES WILLIAM DODGE PLC NPI 1295940690

NPI Information

  • NPI: 1295940690
  • Provider Name: CHARLES WILLIAM DODGE, PLC
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 123 S WASHINGTON ST
    OWOSSO, MI
    ZIP 48867
  • Phone: (989) 723-0330

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NPI Details

Charles William Dodge, PLC is an addiction (substance use disorder) counselor in Owosso, MI. Charles William Dodge, PLC NPI is 1295940690. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

123 S WASHINGTON ST
OWOSSO, MI
ZIP 48867-921
Phone: (989) 723-0330
Fax: (989) 723-0327

The enumeration date for this NPI number is 5/11/2007 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)6401005935MICHIGANYes
2101YP2500XCounselorProfessional6401005935MICHIGANNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11016541MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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