Provider Demographics
NPI:1942331277
Name:WASHO, CHRISTINE ANNE (MS, MSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANNE
Last Name:WASHO
Suffix:
Gender:F
Credentials:MS, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 REGENCY DR E
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-9312
Mailing Address - Country:US
Mailing Address - Phone:217-239-1547
Mailing Address - Fax:217-239-2331
Practice Address - Street 1:1401 REGENCY DR E
Practice Address - Street 2:STE A
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-9312
Practice Address - Country:US
Practice Address - Phone:217-239-1547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0053051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical