Healthcare Provider Details
I. General information
NPI: 1013335686
Provider Name (Legal Business Name): CHANTELL WASHINGTON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/01/2014
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9511 CHEF MENTEUR HWY. STE. 109 #181
NEW ORLEANS LA
70127
US
IV. Provider business mailing address
9511 CHEF MENTEUR HWY. STE. 109 #181
NEW ORLEANS LA
70127
US
V. Phone/Fax
- Phone: 504-681-7108
- Fax:
- Phone: 504-681-7108
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: