Provider Demographics
NPI:1376825216
Name:TOLAND, ASHLEY CANADY (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CANADY
Last Name:TOLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 GULF SHORES PKWY
Mailing Address - Street 2:STE 204
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-6451
Mailing Address - Country:US
Mailing Address - Phone:479-926-3137
Mailing Address - Fax:
Practice Address - Street 1:613 GULF SHORES PKWY
Practice Address - Street 2:STE 204
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-6451
Practice Address - Country:US
Practice Address - Phone:479-926-3137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3870C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR370026YJGYMedicare PIN