Healthcare Provider Details

I. General information

NPI: 1700797560
Provider Name (Legal Business Name): KAMILLE WASHINGTON LPC, PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12480 W 62ND TER STE 101
SHAWNEE KS
66216-1871
US

IV. Provider business mailing address

PO BOX 45486
KANSAS CITY MO
64171-8486
US

V. Phone/Fax

Practice location:
  • Phone: 816-974-3389
  • Fax:
Mailing address:
  • Phone: 816-226-6834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number05559
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2026041489
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: