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General NPI Number Information
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NPI Number | 1942096342
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Entity Type | Individual
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Provider Name | JESSIE WASHINGTON PHD, MSW, MBA
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Gender | Female
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 1325 AVENUE OF THE AMERICAS FL 28
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City | NEW YORK
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State | NY
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Zip | 10019-6583
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Country | US
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Telephone | 718-869-6993
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Fax |
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Provider Business Mailing Address
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Address Line | 1547 CARTER RD
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City | DECATUR
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State | GA
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Zip | 30032-3402
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Country | US
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Telephone | 843-655-7009
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW012128
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License Number State | GA
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