Provider Demographics
NPI:1972480333
Name:WASHINGTON, AMARI T
Entity type:Individual
Prefix:
First Name:AMARI
Middle Name:T
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-4788
Mailing Address - Country:US
Mailing Address - Phone:510-910-4743
Mailing Address - Fax:
Practice Address - Street 1:8788 ELK GROVE BLVD
Practice Address - Street 2:BUILDING 2, SUITE D & E
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1766
Practice Address - Country:US
Practice Address - Phone:916-956-0436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor