MEDICARE: MR. SEBASTIAN WASHBURN LCSW

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	1041C0700X	Clinical Social Worker	68106	TX

General Provider Information

NPI Number	:	1801446166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEBASTIAN WASHBURN LCSW

Provider Business Mailing Address
First Line	:	12337 JONES RD STE 256
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4951
Country	:	US
Telephone Number	:	713-322-6768
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 SOUTHWEST FWY STE 619
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4521
Country	:	US
Telephone Number	:	713-322-6768
Fax Number	:

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

Provider Enumeration Date	:	09/18/2019
Last Update Date	:	03/04/2026

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