Provider Demographics
NPI:1376893149
Name:WASHINGTON, TANYA (LMSW)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LONG VIEW DR. P.O. BOX 572
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10988
Mailing Address - Country:US
Mailing Address - Phone:845-741-6168
Mailing Address - Fax:
Practice Address - Street 1:34 JEANNE DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-741-6168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079368104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker