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Individual

SIOBHAN MONIQUE WASHINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCASA

Contact information

Practice address
12114 DOWNY BIRCH ROAD, CHARLOTTE, NC 28227
(704) 775-1049
Mailing address
12114 DOWNY BIRCH RD, CHARLOTTE, NC 28227-3672

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-21878
NC
251S00000X
Community/Behavioral Health Agency
LCAS-21878
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21878
LCAS
NC
Enumeration date
03/12/2014
Last updated
05/10/2017
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