Provider Demographics
NPI:1710301221
Name:WASHINGTON, DAVID (MSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:MSW
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 1990
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-1990
Mailing Address - Country:US
Mailing Address - Phone:800-892-8900
Mailing Address - Fax:815-338-2912
Practice Address - Street 1:527 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3756
Practice Address - Country:US
Practice Address - Phone:800-892-8900
Practice Address - Fax:815-338-2912
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health