Provider Demographics
NPI:1083880801
Name:CHARIS COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:CHARIS COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BART
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:360-891-2000
Mailing Address - Street 1:11802 NE 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-1560
Mailing Address - Country:US
Mailing Address - Phone:360-891-2000
Mailing Address - Fax:360-944-6965
Practice Address - Street 1:11802 NE 117TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-1560
Practice Address - Country:US
Practice Address - Phone:360-891-2000
Practice Address - Fax:360-944-6965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health