Provider Demographics
NPI:1114223633
Name:GAON, ROBERT ASEOCHE (MHP, AAC, LICSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ASEOCHE
Last Name:GAON
Suffix:
Gender:M
Credentials:MHP, AAC, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:600 BROADWAY
Practice Address - Street 2:SOUND MENTAL HEALTH,
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5229
Practice Address - Country:US
Practice Address - Phone:206-302-2600
Practice Address - Fax:206-302-2610
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60134587101YM0800X, 101YM0800X
WALW60167048104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker