Provider Demographics
NPI:1932446259
Name:WASHINGTON, STEPHEN DION (PHD, CDC I, ABHC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DION
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:PHD, CDC I, ABHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 243534
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99524-3534
Mailing Address - Country:US
Mailing Address - Phone:907-222-2436
Mailing Address - Fax:907-222-2405
Practice Address - Street 1:1565 BRAGAW ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3101
Practice Address - Country:US
Practice Address - Phone:907-222-2436
Practice Address - Fax:907-222-2405
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3833101Y00000X, 101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health