Provider Demographics
NPI:1851971667
Name:WASHINGTON, BRENDA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:ANN
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6720 NEWINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1109
Mailing Address - Country:US
Mailing Address - Phone:703-362-4572
Mailing Address - Fax:
Practice Address - Street 1:6720 NEWINGTON RD
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1109
Practice Address - Country:US
Practice Address - Phone:703-362-4574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical