Healthcare Provider Details

I. General information

NPI: 1154527794
Provider Name (Legal Business Name): CHUCK HOWIE COUNSELING SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 MAGNAVOX WAY SUITE 120
FORT WAYNE IN
46804-1565
US

IV. Provider business mailing address

1415 MAGNAVOX WAY SUITE 120
FORT WAYNE IN
46804-1565
US

V. Phone/Fax

Practice location:
  • Phone: 260-466-3988
  • Fax: 260-483-0836
Mailing address:
  • Phone: 260-466-3988
  • Fax: 260-483-0836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES CLIFFORD HOWIE
Title or Position: PRESIDENT
Credential: MS, LMHC, LPC
Phone: 260-466-3988