Provider Demographics
NPI:1346506490
Name:WASHINGTON, LENISE (BS, MS)
Entity Type:Individual
Prefix:
First Name:LENISE
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:BS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 WHITEFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-4277
Mailing Address - Country:US
Mailing Address - Phone:225-588-3097
Mailing Address - Fax:
Practice Address - Street 1:8323 OHARA CT
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6513
Practice Address - Country:US
Practice Address - Phone:225-388-9844
Practice Address - Fax:225-388-9845
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4821101YM0800X
LA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor