Provider Demographics
NPI:1821313289
Name:WASHINGTON, ANN MARIE (LMSW, ACM)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LMSW, ACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2291 RUSSELL BOND RD
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-5178
Mailing Address - Country:US
Mailing Address - Phone:901-876-6878
Mailing Address - Fax:901-876-6878
Practice Address - Street 1:2291 RUSSELL BOND RD
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-5178
Practice Address - Country:US
Practice Address - Phone:901-876-6878
Practice Address - Fax:901-876-6878
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4483104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker