Provider Demographics
NPI:1730483561
Name:ABERNETHY, ASHLEY BETH (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BETH
Last Name:ABERNETHY
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 1:5320 WHITE STORE RD
Mailing Address - Street 2:
Mailing Address - City:WINGATE
Mailing Address - State:NC
Mailing Address - Zip Code:28174-9755
Mailing Address - Country:US
Mailing Address - Phone:704-389-0114
Mailing Address - Fax:
Practice Address - Street 1:5320 WHITE STORE RD
Practice Address - Street 2:
Practice Address - City:WINGATE
Practice Address - State:NC
Practice Address - Zip Code:28174-9755
Practice Address - Country:US
Practice Address - Phone:704-389-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-09
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0081531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical