Individual
CHARLES WILLIAM DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLC
Contact information
Practice address
123 S WASHINGTON ST, OWOSSO, MI 48867-2921
(989) 723-0330
(989) 723-0327
Mailing address
123 S WASHINGTON ST, OWOSSO, MI 48867-2921
(989) 723-0330
(989) 723-0327
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6401005935
MI
101YP2500X
Professional Counselor
6401005935
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016541
—
MI
Enumeration date
05/11/2007
Last updated
09/11/2025
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