Provider Demographics
NPI:1427689561
Name:WASHINGTON, JARED HAYES (LPC)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:HAYES
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6349 WEDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-8768
Mailing Address - Country:US
Mailing Address - Phone:908-344-7874
Mailing Address - Fax:
Practice Address - Street 1:645 PARIS DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-6138
Practice Address - Country:US
Practice Address - Phone:908-344-7874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011328101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health