Provider Demographics
NPI:1033610977
Name:WASHINGTON, KIRSTEN JANEE
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:JANEE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 375
Mailing Address - Street 2:
Mailing Address - City:PAULINA
Mailing Address - State:LA
Mailing Address - Zip Code:70763-0375
Mailing Address - Country:US
Mailing Address - Phone:504-417-0166
Mailing Address - Fax:
Practice Address - Street 1:14333 PERKINS RD # R
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-3647
Practice Address - Country:US
Practice Address - Phone:225-402-2436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC9547101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health