Provider Demographics
NPI:1023096872
Name:WASHBURN, STEVEN ANDREW (PHD, LPCC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANDREW
Last Name:WASHBURN
Suffix:
Gender:M
Credentials:PHD, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 GEORGIA ST NE
Mailing Address - Street 2:SUITE B 2
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1359
Mailing Address - Country:US
Mailing Address - Phone:505-837-1177
Mailing Address - Fax:505-872-8045
Practice Address - Street 1:3901 GEORGIA ST NE
Practice Address - Street 2:SUITE B 2
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1359
Practice Address - Country:US
Practice Address - Phone:505-837-1177
Practice Address - Fax:505-872-8045
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0404101YP2500X
NMM-1658104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM10007274OtherLOVELACE HEALTH PLAN
NM7360231OtherAETNA
NM425379OtherPRIVATE HEALTH CARE
NM63428OtherCIGNA
NMNM00R398OtherBLUE CROSS BLUE SHIELD OF
NMNM100981OtherVALUE OPTIONS OF NEW MEXI
NM293894OtherUNITED BEHAVIORAL HEALTH