Provider Demographics
NPI:1639545858
Name:COLEMAN, ASHLEY (LCSW-A)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 VERANDA TRL
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:GA
Mailing Address - Zip Code:31320-2310
Mailing Address - Country:US
Mailing Address - Phone:864-909-9272
Mailing Address - Fax:
Practice Address - Street 1:136 MARGINAL ST
Practice Address - Street 2:
Practice Address - City:COOLEEMEE
Practice Address - State:NC
Practice Address - Zip Code:27014-0168
Practice Address - Country:US
Practice Address - Phone:363-284-2581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0095421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical