Provider Demographics
NPI:1598994170
Name:CHRISTMON-WASHINGTON, DARLENE K (PMHCNS-BC)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:K
Last Name:CHRISTMON-WASHINGTON
Suffix:
Gender:F
Credentials:PMHCNS-BC
Other - Prefix:
Other - First Name:DARLENE
Other - Middle Name:K
Other - Last Name:CHRISTMON-WASHINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:455 LAKESHORE PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4205
Mailing Address - Country:US
Mailing Address - Phone:038-909-6363
Mailing Address - Fax:
Practice Address - Street 1:455 LAKESHORE PKWY
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4205
Practice Address - Country:US
Practice Address - Phone:803-909-6363
Practice Address - Fax:803-909-6364
Is Sole Proprietor?:No
Enumeration Date:2009-07-05
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003146364SP0809X
IN28123661A163WP0809X
SC23430364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult