Provider Demographics
NPI:1275976565
Name:WASHINGTON, DENISE ANN (MPA, LSW)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:ANN
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MPA, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CLAPP ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-2003
Mailing Address - Country:US
Mailing Address - Phone:617-201-2239
Mailing Address - Fax:
Practice Address - Street 1:5 CLAPP ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-2003
Practice Address - Country:US
Practice Address - Phone:617-201-2239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3021012104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker