Provider Demographics
NPI:1730937228
Name:WASHINGTON, KASANDRA MARIA (MA, LPC)
Entity type:Individual
Prefix:
First Name:KASANDRA
Middle Name:MARIA
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:KASANDRA
Other - Middle Name:MARIA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:129 KODIAK DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-4073
Mailing Address - Country:US
Mailing Address - Phone:512-917-0658
Mailing Address - Fax:
Practice Address - Street 1:129 KODIAK DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-4073
Practice Address - Country:US
Practice Address - Phone:512-917-0658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87530101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional