Provider Demographics
NPI:1851668206
Name:GAFFNEY, ROBERT (MA, CRC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:GAFFNEY
Suffix:
Gender:M
Credentials:MA, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 E EVERGREEN BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-4322
Mailing Address - Country:US
Mailing Address - Phone:360-694-6416
Mailing Address - Fax:360-694-8534
Practice Address - Street 1:2503 E EVERGREEN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-4322
Practice Address - Country:US
Practice Address - Phone:360-694-6416
Practice Address - Fax:360-694-8534
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60174992101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60174992OtherLMHC
285941OtherNATIONAL BOARD FOR CERTIFIED COUNSELORS