Basic Information
| Provider Information | |||||||||
| NPI: | 1831180728 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNARD | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | MA, LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1104 MAIN ST | ||||||||
| Address2: | SUITE 440 | ||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986602999 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606945022 | ||||||||
| FaxNumber: | 3607357484 | ||||||||
| Practice Location | |||||||||
| Address1: | 1104 MAIN ST | ||||||||
| Address2: | SUITE 440 | ||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986602999 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606945022 | ||||||||
| FaxNumber: | 3607357484 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LHOOOO3813 | WA | X | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | LH00003813 | WA | X | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.