Provider Demographics
NPI:1730943531
Name:WASHINGTON, NAYA (LMSW)
Entity type:Individual
Prefix:
First Name:NAYA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 PAYTON DR N
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-8460
Mailing Address - Country:US
Mailing Address - Phone:501-508-3813
Mailing Address - Fax:
Practice Address - Street 1:1233 PAYTON DR N
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-8460
Practice Address - Country:US
Practice Address - Phone:501-508-3813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSM10758104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker