Provider Demographics
NPI:1316488398
Name:DOLIFKA, CHARLOTTE SUE (LPC)
Entity type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:SUE
Last Name:DOLIFKA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 PROSPECTOR TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-2700
Mailing Address - Country:US
Mailing Address - Phone:254-650-1512
Mailing Address - Fax:254-690-1532
Practice Address - Street 1:880 PROSPECTOR TRL STE 100
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2700
Practice Address - Country:US
Practice Address - Phone:254-247-9766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-10
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68901101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor