Provider Demographics
NPI:1497330534
Name:WASHINGTON, DAJANAE CHARICE (LLMSW)
Entity Type:Individual
Prefix:MRS
First Name:DAJANAE
Middle Name:CHARICE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:MS
Other - First Name:DAJANAE
Other - Middle Name:CHARICE
Other - Last Name:GASTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:703 LIVERNOIS ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-2306
Mailing Address - Country:US
Mailing Address - Phone:248-955-3219
Mailing Address - Fax:
Practice Address - Street 1:703 LIVERNOIS ST
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2306
Practice Address - Country:US
Practice Address - Phone:248-955-3219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011091461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical