Provider Demographics
NPI:1942832589
Name:WASHER, ROBERT DREW (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DREW
Last Name:WASHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 SANDERCOCK ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-5145
Mailing Address - Country:US
Mailing Address - Phone:805-235-5788
Mailing Address - Fax:805-545-3111
Practice Address - Street 1:419 SANDERCOCK ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-5145
Practice Address - Country:US
Practice Address - Phone:805-235-5788
Practice Address - Fax:805-545-3111
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty