Charboneau, Gregory J.
Charboneau, Gregory J. is an sole proprietor health care provider with primary practice located at 3157 E. 17Th Avenue , Spokane WA 99223-5136. He recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Health, Behavioral Health & Social Service Providers / Health Service. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Charboneau, Gregory J. can be contacted via phone (509) 838-8066.Contact Information
Primary practice address
3157 E. 17Th Avenue
Spokane WA 99223-5136
Phone: (509) 838-8066
Fax: (800) 594-8305
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2046 | Washington |
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | WA.LIC2046 | Washington |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | ||
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | ||
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | ||
| Behavioral Health & Social Service Providers / Health | 103TH0004X | ||
| Behavioral Health & Social Service Providers / Health Service | 103TH0100X |
Profile Details
| NPI number | 1790773463 |
|---|---|
| LBN Legal business name | Charboneau, Gregory J. |
| Credentials | EDD, BCN, BCB |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 7th, 2005 |
| Last updated | Nov 14th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790773463 | NPPES |
| Other | 80159590 | APA# |
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