Provider Demographics
NPI:1497720031
Name:WASHINGTON, LORRAINE NONE (LSWA)
Entity Type:Individual
Prefix:MISS
First Name:LORRAINE
Middle Name:NONE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 LAKE PARK DR
Mailing Address - Street 2:102
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3071
Mailing Address - Country:US
Mailing Address - Phone:202-939-7634
Mailing Address - Fax:202-939-7659
Practice Address - Street 1:1407 S ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-3819
Practice Address - Country:US
Practice Address - Phone:202-797-4425
Practice Address - Fax:202-797-4426
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLA114104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker