Healthcare Provider Details

I. General information

NPI: 1205342201
Provider Name (Legal Business Name): ALEXANDRIA DEANNA WASHINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 S HOLLY ST APT 210
DENVER CO
80222-3956
US

IV. Provider business mailing address

805 N BEECH ST STE 2
TALLULAH LA
71282-3809
US

V. Phone/Fax

Practice location:
  • Phone: 702-721-1177
  • Fax: 702-721-1177
Mailing address:
  • Phone: 318-493-5147
  • Fax: 318-493-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW.0009925855
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: