Provider Demographics
NPI:1922854538
Name:WASHINGTON, CHRISTINE CARROLL
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CARROLL
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 1:7736 MARY PAGE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23237-2473
Mailing Address - Country:US
Mailing Address - Phone:804-536-8467
Mailing Address - Fax:804-275-1002
Practice Address - Street 1:7736 MARY PAGE LN
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23237-2473
Practice Address - Country:US
Practice Address - Phone:804-536-8467
Practice Address - Fax:804-275-1002
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional