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General NPI Number Information
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NPI Number | 1205951779
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Entity Type | Individual
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Provider Name | CHARLES JAMES VERRO MA, LMHC
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 11/12/2018
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Provider Practice Location Address
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Address Line | 314 W 15TH ST STE 200
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City | VANCOUVER
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State | WA
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Zip | 98660-2927
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Country | US
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Telephone | 360-696-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 14623 NE 50TH ST
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City | VANCOUVER
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State | WA
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Zip | 98682-6064
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Country | US
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Telephone | 360-696-3600
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Fax | 360-696-3616
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LH00008656
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License Number State | WA
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