Provider Demographics
NPI:1891297503
Name:GILMORE, ASHLEY PARTAIN (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:PARTAIN
Last Name:GILMORE
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 1:9941 LINGO LN # 160
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-3349
Mailing Address - Country:US
Mailing Address - Phone:972-502-4108
Mailing Address - Fax:214-932-7534
Practice Address - Street 1:9941 LINGO LN # 160
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-3349
Practice Address - Country:US
Practice Address - Phone:972-502-4108
Practice Address - Fax:214-932-7534
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX524091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical