Provider Demographics
NPI:1649982042
Name:GARRICK, ASHLEY RA'QUELLE (LISW-CP)
Entity type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:RA'QUELLE
Last Name:GARRICK
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1839 EBENEZER RD APT D
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1139
Mailing Address - Country:US
Mailing Address - Phone:954-294-8339
Mailing Address - Fax:
Practice Address - Street 1:1839 EBENEZER RD APT D
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1139
Practice Address - Country:US
Practice Address - Phone:954-294-8339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC154781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical