Healthcare Provider Details

I. General information

NPI: 1427633072
Provider Name (Legal Business Name): SHAKYRA MARIE WASHINGTON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date: 09/20/2024
Reactivation Date: 10/08/2024

III. Provider practice location address

5900 BALCONES DR STE 100
AUSTIN TX
78731-4298
US

IV. Provider business mailing address

5900 BALCONES DR STE 100 SUITE 24270
AUSTIN TX
78731-4298
US

V. Phone/Fax

Practice location:
  • Phone: 328-416-1239
  • Fax:
Mailing address:
  • Phone: 328-416-1239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number96564
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-159684
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: