Individual provider Active NPI

Sean D Washington, LCMHC-A

  • Professional Counselor
  • Charlotte, NC
National Provider Identifier
1699422816
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A17415 Issued in NC
Practice address
2315 E WT Harris Blvd Ste 102
Charlotte, NC 28213-5133
Phone
(704) 208-4458
NPI assigned
Mar 8, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A17415 NC Primary

Addresses

Primary practice location

2315 E WT Harris Blvd Ste 102
Charlotte, NC 28213-5133

Mailing address

7717 Bridle CT
Charlotte, NC 28216-8730
Phone (704) 430-9805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A17415NCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1699422816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7717 BRIDLE CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282168730",
            "telephone_number": "704-430-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E WT HARRIS BLVD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282135133",
            "telephone_number": "704-208-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "SEAN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LCMHC-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A17415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.