Basic Information
| Provider Information | |||||||||
| NPI: | 1679698070 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HONIGFORD | ||||||||
| FirstName: | CHARLES | ||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 530 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458041240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192221168 | ||||||||
| FaxNumber: | 4192222158 | ||||||||
| Practice Location | |||||||||
| Address1: | 720 ARMSTRONG ST | ||||||||
| Address2: | |||||||||
| City: | SAINT MARYS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458851800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193947451 | ||||||||
| FaxNumber: | 4193948051 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 05/14/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | E-0002774 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.