Provider Demographics
NPI:1235387952
Name:WASHINGTON, MEADOW LARK (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:MEADOW
Middle Name:LARK
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 W JOPPA RD
Mailing Address - Street 2:SUITE 229
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4624
Mailing Address - Country:US
Mailing Address - Phone:410-339-5775
Mailing Address - Fax:
Practice Address - Street 1:2360 W JOPPA RD
Practice Address - Street 2:SUITE 229
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4624
Practice Address - Country:US
Practice Address - Phone:410-339-5775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health