Demetrius Dewyane Washington

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

324 N 13TH Ave
1901 Baker Street
Arcadia, FL 34266-8922

Phone

(863) 244-2836

NPI assigned

Oct 20, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1164826194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 N 13TH AVE",
            "address_2": "1901 BAKER STREET",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668922",
            "telephone_number": "863-244-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 N 13TH AVE",
            "address_2": "1901 BAKER STREET",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668922",
            "telephone_number": "863-244-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "DEMETRIUS",
        "middle_name": "DEWYANE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "101YM0800X",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Arcadia, FL
• Providers in Arcadia, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.