Provider Demographics
NPI:1942548201
Name:DANIEL, ASHLEY FARRIS (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:FARRIS
Last Name:DANIEL
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 1:1818 AVENUE OF AMERICA
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-4530
Mailing Address - Country:US
Mailing Address - Phone:318-998-2700
Mailing Address - Fax:318-998-2703
Practice Address - Street 1:1818 AVENUE OF AMERICA
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-4530
Practice Address - Country:US
Practice Address - Phone:318-998-2700
Practice Address - Fax:318-998-2703
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical