CHARLES R OBANNON (NPI# 1720496730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720496730 |
| Entity Type | Organization |
| Organization Name | CHARLES R OBANNON |
| Other Organization Name | RENAISSANCE COUNSELING LLC |
| Practice Address |
31090 Se Division Dr Troutdale OR 97060-9451 |
| Practice Telephone | 5036188041 |
| Practice Fax Number | 5036188052 |
| Mailing Telephone | 5036188041 |
| Mailing Fax Number | 5036188052 |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | DR. CHARLES RICHARD O'BANNON (LICENSED PSYCHOLOGIST / OWNER) |
| Authorized Official Telephone | 5036188041 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| RENAISSANCE COUNSELING LLC | Doing Business As Name - Organization |
| Street Address |
31090 SE DIVISION DR |
| City | TROUTDALE |
| State | OR |
| Zip Code | 97060-9451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861921124 | Kayla Michelle Stewart | Doula | 424 Se 19th St, Troutdale, OR 97060 | 2017-06-08 |
| 1467856955 | Meghan Ellen Revoir Bennett | Naturopath | 330 Se 3rd Street, Troutdale, OR 97060 | 2014-10-13 |
| 1699012310 | Scott C Williams | Pharmacist | 22855 N.e. Parklane, Wood Village, OR 97060 | 2013-01-15 |
| 1285888636 | Dan E. Cox | Counselor | 107 E. Historic Columbia River Hwy, Suite 207, Troutdale, OR 97060 | 2008-11-12 |
| 1356592596 | Emily J White | Pulmonary Function Technologist | 735 Sw 14th St, Troutdale, OR 97060 | 2008-10-07 |
| 1497905772 | Fred Meyer | Pharmacist | 22855 Ne Parklane, Wood Village, OR 97060 | 2008-09-24 |
| 1104072057 | Sharon Brennan | Nurse Practitioner | 2800 Sw 257th Avenue, Columbia View Family Health Center, Troutdale, OR 97060 | 2008-08-12 |
| 1902094386 | Steven Gary Cranford | Chiropractor | 1530 Sw 257th Dr., Troutdale, OR 97060 | 2007-10-10 |
| 1750581062 | Gresham-troutdale Family Medical Center | Non-Pharmacy Dispensing Site | 1700 Sw 27th Ave, Troutdale, OR 97060 | 2007-07-24 |
| 1710181755 | Valerie Kay Robertson | Specialist | 3703 Se 39th, Portland, OR 97060 | 2007-06-13 |
| Find all providers in zip 97060 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013925148 | Amy Lynn Salazar | Psychologist | 107 E Historic Columbia River Hwy, Ste 208, Troutdale, OR 97060-2093 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1407453889 | Larissa Catherine Miller | Psychologist | 2920 Alder St, Eugene, OR 97405-4146 | 2020-10-08 |
| 1356958672 | Lighthouse Psychological Services, LLC | Psychologist | 630 Sw Nevada St, Ste. E, Poralnd, OR 97219 | 2020-09-30 |
| 1619583408 | Kyleemillerphd | Psychologist | 586 Welcome Way Se, Salem, OR 97302-3932 | 2020-09-17 |
| 1740890771 | Marion David | Psychologist | 8228 Sw 171st Place, First Floor, Beaverton, OR 97007-6787 | 2020-08-04 |
| 1679182364 | Psychological Services of Pendleton, LLC | Psychologist | 1100 Southgate Ste 13, Pendleton, OR 97801-3973 | 2020-07-28 |
| 1497373021 | Jennifer Schmidt | Psychologist | 995 Stonewater Dr., Eagle Point, OR 97524 | 2020-07-09 |
| 1063039592 | Cyti Psychology LLC | Psychologist | 12205 Sw Tualatin Rd Ste 270, Tualatin, OR 97062-7623 | 2020-06-30 |
| 1811518434 | Nathaniel Israel | Psychologist | 7419 Se Woodstock Blvd, Portland, OR 97206-5838 | 2020-05-05 |
| 1477198315 | Emi Sumida Brown | Psychologist | 993 Nw Circle Blvd Ste A, Corvallis, OR 97330-1408 | 2019-11-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.