Provider Demographics
NPI:1639594302
Name:WASHINGTON,, CORINTHIANS (DO, EDD, CDCA)
Entity Type:Individual
Prefix:DR
First Name:CORINTHIANS
Middle Name:
Last Name:WASHINGTON,
Suffix:
Gender:M
Credentials:DO, EDD, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4732
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31914-0732
Mailing Address - Country:US
Mailing Address - Phone:706-341-1377
Mailing Address - Fax:
Practice Address - Street 1:6600 VAN AALST BLVD
Practice Address - Street 2:
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905-2102
Practice Address - Country:US
Practice Address - Phone:706-406-3309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA172565101YA0400X
171M00000X
GA033002084P0800X
GA155062171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry