Doctor Name: | ELLIOTT WASHINGTON |
NPI Number: | 1063887784 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A., BCCC |
License Number: | 0608 |
Business Practice Address: | 3950 Cobb Pkwy Nw Ste 902 Acworth, GA - 301019525 |
Business Phone Number: | 8009105060 |
Business Fax Number: | 8006346360 |
Mailing Address: | 3950 Cobb Pkwy Nw Ste 902, ACWORTH |
State: | GA |
Postal Code: | 301019525 |
Phone Number: | 8009105060 |
Fax Number: | 8006346360 |
NPI Enumeration Date: | 12/07/2015 |
NPI Last Update Date: | 12/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0608 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |