Provider Demographics
NPI:1336822576
Name:CLIBORNE, ASHLEY ESTELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ESTELLE
Last Name:CLIBORNE
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 1:13805 VILLAGE MILL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-4304
Mailing Address - Country:US
Mailing Address - Phone:804-404-6553
Mailing Address - Fax:
Practice Address - Street 1:13805 VILLAGE MILL DR STE 201
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-4304
Practice Address - Country:US
Practice Address - Phone:804-404-6553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040154531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical