Provider Demographics
NPI:1083492854
Name:WASHINGTON, AUTUMN MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:MICHELLE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14832 E 119TH AVE
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80603-7259
Mailing Address - Country:US
Mailing Address - Phone:303-521-7627
Mailing Address - Fax:
Practice Address - Street 1:14832 E 119TH AVE
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80603-7259
Practice Address - Country:US
Practice Address - Phone:303-521-7627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0018198101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health