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General NPI Number Information
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NPI Number | 1487466421
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Entity Type | Individual
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Provider Name | SHAWN LEVINE WASHINGTON BS, NCACII, CSAC,
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Gender | Male
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 211 GIBSON ST NW STE 123
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City | LEESBURG
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State | VA
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Zip | 20176-2115
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Country | US
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Telephone | 571-561-3040
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Fax |
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Provider Business Mailing Address
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Address Line | 211 GIBSON ST NW STE 123
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City | LEESBURG
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State | VA
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Zip | 20176-2115
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Country | US
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Telephone | 571-561-3040
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 0710103072
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0710103072
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License Number State | VA
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