Provider Demographics
NPI:1619411287
Name:WASHINGTON, ASHANTI
Entity Type:Individual
Prefix:
First Name:ASHANTI
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 LAKE FOREST BLVD STE 607
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-6201
Mailing Address - Country:US
Mailing Address - Phone:504-265-1230
Mailing Address - Fax:504-324-0476
Practice Address - Street 1:10001 LAKE FOREST BLVD STE 607
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-6201
Practice Address - Country:US
Practice Address - Phone:504-265-1230
Practice Address - Fax:504-324-0476
Is Sole Proprietor?:No
Enumeration Date:2016-12-15
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 106S00000X
LA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator