Jacqueline Denise Washington, MENTAL HEALTH

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Practice address

224 Dallas St
Gary, IN 46406-1327

Phone

(219) 248-5307

NPI assigned

Aug 21, 2023

Last updated

Aug 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jacqueline Denise Washington Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1801670831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 DALLAS ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464061327",
            "telephone_number": "219-248-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 DALLAS ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464061327",
            "telephone_number": "219-248-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "JACQUELINE",
        "middle_name": "DENISE",
        "credential": "MENTAL HEALTH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "WASHINGTON",
            "middle_name": "DENISE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Karin Adine Warden-Thomas, FNP-BC
• Deanna Ione Ware
• Michelle Ware
• Renita Ware
• Audric Ranel Warren, MS, ATC, PES, CES
• Mark Alan Washington, M.D.
• Yassmine Washington
• Michelle Wathier, NP
• Channae Watkins, NP
• Neil Lawrence Watkins, MD

• Adult Mental Health Clinic/Center in Gary, IN
• Providers in Gary, IN by specialty
• Adult Mental Health Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.