Provider Demographics
NPI:1245524883
Name:UNDERWOOD, ASHLEY (LCSW, PIP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4245 OLD CAHABA PKWY
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-8024
Mailing Address - Country:US
Mailing Address - Phone:205-983-4450
Mailing Address - Fax:205-449-7782
Practice Address - Street 1:3100 LORNA RD STE 211
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-5451
Practice Address - Country:US
Practice Address - Phone:205-983-4450
Practice Address - Fax:205-449-7782
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0867-2098C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL12178649OtherCAQH