Provider Demographics
NPI:1780182717
Name:WASHINGTON, CRYSTAL MONEL
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:MONEL
Last Name:WASHINGTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 SAN CLEMENTE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-1271
Mailing Address - Country:US
Mailing Address - Phone:225-384-0231
Mailing Address - Fax:225-460-8719
Practice Address - Street 1:2229 SAN CLEMENTE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-1271
Practice Address - Country:US
Practice Address - Phone:225-384-0231
Practice Address - Fax:225-460-8719
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC8754171M00000X, 101Y00000X, 101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health