National Provider Identifier
Jacque Tara Washington, LCSW
Jacque Tara Washington, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Ithaca, NY and a listed phone number of (607) 274-6230.
Profile Overview
- NPI
- 1265671150
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- February 17, 2009
- Last Updated
- November 30, 2015
Practice Location
- 201 E. Green St
- Ithaca, NY 14850-5421
Phone: (607) 274-6230
Specialties
- Clinical Social Worker (1041C0700X)
- Clinical Social Worker (1041C0700X)
- Mental Health Counselor (101YM0800X)
Full Record
- NPI
- 1265671150
- Entity Type
- Individual
- Last Name
- Washington
- First Name
- Jacque
- Middle Name
- Tara
- Credential
- LCSW
- Mailing Street Address
- 201 E. Green St
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-5421
- Mailing Country
- US
- Mailing Phone
- (607) 274-6230
- Mailing Fax
- (607) 274-6316
- Practice Street Address
- 201 E. Green St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5421
- Practice Country
- US
- Practice Phone
- (607) 274-6230
- Practice Fax
- (607) 274-6316
- Enumeration Date
- February 17, 2009
- Last Updated
- November 30, 2015
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X), Clinical Social Worker (1041C0700X), Mental Health Counselor (101YM0800X)