Provider Demographics
NPI:1336497791
Name:MITCHELL WASHINGTON, AISHA RESHA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AISHA
Middle Name:RESHA
Last Name:MITCHELL WASHINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:AISHA
Other - Middle Name:RESHA
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:90F GLENDA TRCE
Mailing Address - Street 2:# 306
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-3858
Mailing Address - Country:US
Mailing Address - Phone:762-499-7823
Mailing Address - Fax:
Practice Address - Street 1:19 GREENCOVE CT
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-3391
Practice Address - Country:US
Practice Address - Phone:334-782-2743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2451C1041C0700X
GACSW0046771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical