Provider Demographics
NPI:1619148061
Name:CHRISTAL, ROBERT W (LMHC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:CHRISTAL
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:BO
Other - Middle Name:W
Other - Last Name:CHRISTAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:208 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2105
Mailing Address - Country:US
Mailing Address - Phone:509-387-1799
Mailing Address - Fax:
Practice Address - Street 1:208 N CHELAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2105
Practice Address - Country:US
Practice Address - Phone:509-387-1799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011292101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health