Provider Demographics
NPI:1881769511
Name:VANMALE, ROBERT J (MS, LMHC, CMHS, MHP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:VANMALE
Suffix:
Gender:M
Credentials:MS, LMHC, CMHS, MHP
Other - Prefix:
Other - First Name:BOB
Other - Middle Name:
Other - Last Name:VAN MALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:133 S 44TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2865
Mailing Address - Country:US
Mailing Address - Phone:360-756-6161
Mailing Address - Fax:
Practice Address - Street 1:2500 E COLLEGE WAY
Practice Address - Street 2:STE 100
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-5862
Practice Address - Country:US
Practice Address - Phone:360-428-8912
Practice Address - Fax:360-424-6288
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010162101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00046354OtherREGISTERED COUNSELOR
WALH00010162OtherLICENSED MH COUNSELOR