MEDICARE: CHRISTOPHER WASHINGTON LPC ASSOCIATE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		TX

General Provider Information

NPI Number	:	1417772732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER WASHINGTON LPC ASSOCIATE

Provider Business Mailing Address
First Line	:	412 RED RIVER TRL APT 1040
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-6509
Country	:	US
Telephone Number	:	718-791-0976
Fax Number	:

Provider Business Practice Location Address
First Line	:	12801 N CENTRAL EXPY STE 1727
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-1716
Country	:	US
Telephone Number	:	972-464-8668
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2024
Last Update Date	:	11/21/2024

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