Provider Demographics
NPI:1619025012
Name:AINSWORTH, MARTHA P (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:P
Last Name:AINSWORTH
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 1:852 CLAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3002
Mailing Address - Country:US
Mailing Address - Phone:615-298-2942
Mailing Address - Fax:615-321-4157
Practice Address - Street 1:852 CLAYTON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3002
Practice Address - Country:US
Practice Address - Phone:615-298-2942
Practice Address - Fax:615-321-4157
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical