Provider Demographics
NPI:1720243389
Name:NAZWORTH, ASHLEY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:NAZWORTH
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 1:300 VEAZEY RD
Mailing Address - Street 2:
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509
Mailing Address - Country:US
Mailing Address - Phone:919-764-5410
Mailing Address - Fax:919-764-5497
Practice Address - Street 1:300 VEAZEY RD
Practice Address - Street 2:
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-3703
Practice Address - Country:US
Practice Address - Phone:919-764-5410
Practice Address - Fax:919-764-5497
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0061031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical