Provider Demographics
NPI:1962777284
Name:SPAULDING, AMBROSIA (MSW, LCSW, LCAS)
Entity type:Individual
Prefix:
First Name:AMBROSIA
Middle Name:
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 SPAULDING LN
Mailing Address - Street 2:
Mailing Address - City:CLARKTON
Mailing Address - State:NC
Mailing Address - Zip Code:28433-6003
Mailing Address - Country:US
Mailing Address - Phone:910-302-8494
Mailing Address - Fax:
Practice Address - Street 1:68 SPAULDING LN
Practice Address - Street 2:
Practice Address - City:CLARKTON
Practice Address - State:NC
Practice Address - Zip Code:28433-6003
Practice Address - Country:US
Practice Address - Phone:910-302-8494
Practice Address - Fax:910-679-6348
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0095521041C0700X
SC147111041C0700X
WI17186-132101YA0400X
TX1173681041C0700X
NCLCAS20725101YA0400X
FLSW191751041C0700X
WI11820-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)