Provider Demographics
NPI:1205342201
Name:WASHINGTON, ALEXANDRIA DEANNA
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:DEANNA
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 N BEECH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71282-3809
Mailing Address - Country:US
Mailing Address - Phone:318-493-5147
Mailing Address - Fax:318-493-5148
Practice Address - Street 1:1525 S HOLLY ST APT 210
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3956
Practice Address - Country:US
Practice Address - Phone:702-721-1177
Practice Address - Fax:702-721-1177
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-28
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 1041C0700X, 225400000X
COLSW.0009925855104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner