Provider Demographics
NPI:1962836981
Name:MIRAMBELL, ASHLEY ANTHONY (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANTHONY
Last Name:MIRAMBELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:KAY
Other - Last Name:ANTHONY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, LCSW
Mailing Address - Street 1:3613 HESSMER AVE.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5011
Mailing Address - Country:US
Mailing Address - Phone:504-813-7947
Mailing Address - Fax:
Practice Address - Street 1:3613 HESSMER AVE STE 101
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4876
Practice Address - Country:US
Practice Address - Phone:504-324-7922
Practice Address - Fax:504-324-8698
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11587104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker