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Individual
CHARLES DICKERMAN
Active
Individual
CHARLES DICKERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT, CADC III, SUDP
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11-06-19
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60796757
WA
106H00000X
Marriage & Family Therapist
Primary
T0866
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
04/03/2008
Last updated
12/27/2023
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