Provider Demographics
NPI:1033178991
Name:ASHMORE, CHRISTINE MARY (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARY
Last Name:ASHMORE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WINDHOVER PL
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5151
Mailing Address - Country:US
Mailing Address - Phone:919-240-4538
Mailing Address - Fax:
Practice Address - Street 1:103 WINDHOVER PL
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5151
Practice Address - Country:US
Practice Address - Phone:919-240-4538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10248291041C0700X
NCC0070011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical