Provider Demographics
NPI:1720867344
Name:WASHINGTON, CHRISTINA (LMSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 WHISPER TRL
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1403
Mailing Address - Country:US
Mailing Address - Phone:404-997-9069
Mailing Address - Fax:
Practice Address - Street 1:8335 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-6937
Practice Address - Country:US
Practice Address - Phone:678-324-0476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA137762801101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health