Provider Demographics
NPI:1134677172
Name:WASHINGTON, ALICIA RENEE (RSW)
Entity Type:Individual
Prefix:MISS
First Name:ALICIA
Middle Name:RENEE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:RSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5174 SAINT ANTHONY AVE
Mailing Address - Street 2:APT D
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4056
Mailing Address - Country:US
Mailing Address - Phone:504-333-9230
Mailing Address - Fax:
Practice Address - Street 1:5174 SAINT ANTHONY AVE
Practice Address - Street 2:APT D
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-4056
Practice Address - Country:US
Practice Address - Phone:504-333-9230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12704101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health