Joemal D Bonneau, CADC Candidate/QMHA
Counselor, Addiction (Substance Use Disorder) in Gresham, OR. Individual provider (NPI-1).
NPI number1376995043
StatusActive
Last updated in NPPESMar 17, 2018
Details
- NPI
- 1376995043
- Entity type
- Individual (NPI-1)
- Name
- Joemal D Bonneau
- Credential
- CADC Candidate/QMHA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 6, 2016
- Last updated
- Mar 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | T-16-238 | OR | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | OR | |
| 101YM0800X | Counselor, Mental Health | – | OR |
Practice location
620 Ne 2nd StGresham, OR 97030-7514
Phone 971-274-3757 · Fax 503-912-5740
Mailing address
1776 Sw Madison StPortland, OR 97205-1715
Phone 503-224-1044 · Fax 503-621-2235
Other practice locations
10822 Se 82nd Ave
Happy Valley, OR 97086
Happy Valley, OR 97086
Phone 503-654-7444
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