Provider Demographics
NPI:1548773062
Name:WASHINGTON, JAZZ LAMAR (LPC)
Entity type:Individual
Prefix:MR
First Name:JAZZ
Middle Name:LAMAR
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 1:1112 E COPELAND RD STE 420
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-1315
Mailing Address - Country:US
Mailing Address - Phone:817-631-0976
Mailing Address - Fax:
Practice Address - Street 1:1112 E COPELAND RD STE 420
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-1315
Practice Address - Country:US
Practice Address - Phone:817-631-0976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCOU.7523101YP2500X
TX89459101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional