Provider Demographics
NPI:1326402033
Name:WASHINGTON, SERGIO D (MS)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:D
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 HORNADY DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36460-8658
Mailing Address - Country:US
Mailing Address - Phone:251-575-4837
Mailing Address - Fax:
Practice Address - Street 1:530 HORNADY DR
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-8658
Practice Address - Country:US
Practice Address - Phone:251-575-4837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health