Provider Demographics
NPI:1114210093
Name:WASHINGTON, MARTHA (LPC)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8303 SOUTHWEST FREEWAY SUITE #250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:832-309-6213
Mailing Address - Fax:
Practice Address - Street 1:8303 SOUTHWEST FWY STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1691
Practice Address - Country:US
Practice Address - Phone:832-309-6213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX506637802OtherUNITED BEHAVIROL HEALTH
TX506637802OtherAMERIGROUP