Provider Demographics
NPI:1306270517
Name:WASHINGTON, CHEVAR MARTYSE (LCSWA)
Entity type:Individual
Prefix:MS
First Name:CHEVAR
Middle Name:MARTYSE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 TECHNICAL CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2873
Mailing Address - Country:US
Mailing Address - Phone:919-264-5332
Mailing Address - Fax:888-316-3694
Practice Address - Street 1:349 TECHNICAL CT
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-2873
Practice Address - Country:US
Practice Address - Phone:919-264-5332
Practice Address - Fax:888-316-3694
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0071481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical