MEDICARE: BRITTANY WASHINGTON LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	62726	TX

General Provider Information

NPI Number	:	1770200198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY WASHINGTON LMSW

Provider Business Mailing Address
First Line	:	220 E BROADWAY AVE APT 1408
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-1375
Country	:	US
Telephone Number	:	469-616-0214
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 E BROADWAY AVE APT 1408
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-1375
Country	:	US
Telephone Number	:	469-616-0214
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2022
Last Update Date	:	10/26/2022

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