# CHARLES DICKERMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1548433261
- **Gender:** Man
- **Credential:** LMFT, CADC III, SUDP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 11-06-19 | OR | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | CP60796757 | WA | — |
| 106H00000X | Marriage & Family Therapist | T0866 | OR | Yes |

## Other

- **Enumeration date:** 04/03/2008
- **Last updated:** 12/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 164936 | — | OR |