Healthcare Provider Details

I. General information

NPI: 1730043282
Provider Name (Legal Business Name): COURTNEY DAWN WASHINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 CLOVIS AVE
CAPITOL HEIGHTS MD
20743-3942
US

IV. Provider business mailing address

823 CLOVIS AVE
CAPITOL HEIGHTS MD
20743-3942
US

V. Phone/Fax

Practice location:
  • Phone: 240-586-4248
  • Fax: 240-586-4248
Mailing address:
  • Phone: 240-586-4248
  • Fax: 240-586-4248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGPC200001900
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: