MEDICARE: MR. WILLIAM CLARENCE WASHINGTON

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	E.2102105	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841656394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM CLARENCE WASHINGTON

Provider Business Mailing Address
First Line	:	PO BOX 19425
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-0425
Country	:	US
Telephone Number	:	865-773-9632
Fax Number	:	216-486-8147

Provider Business Practice Location Address
First Line	:	814 E 185TH ST STE 300
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-2775
Country	:	US
Telephone Number	:	166-819-2642
Fax Number	:	216-282-8596

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

Provider Enumeration Date	:	01/13/2016
Last Update Date	:	03/18/2021

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Directions to “ MR. WILLIAM CLARENCE WASHINGTON ” Practice Location

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