Healthcare Provider Details

I. General information

NPI: 1639263247
Provider Name (Legal Business Name): CHARLES G INGLE LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 COUNTY LINE RD
RUNNELLS IA
50237-7508
US

IV. Provider business mailing address

210 COUNTY LINE RD
RUNNELLS IA
50237-7508
US

V. Phone/Fax

Practice location:
  • Phone: 515-238-3316
  • Fax:
Mailing address:
  • Phone: 515-238-3316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number00081
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2022013578M
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: