Provider Demographics
NPI:1740634088
Name:WILLIAMS, ASHLEY (LCSW-A)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
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 1:2644 MULBERRY POND DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-2590
Mailing Address - Country:US
Mailing Address - Phone:704-450-7580
Mailing Address - Fax:
Practice Address - Street 1:3707 LATROBE DR STE 450
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1361
Practice Address - Country:US
Practice Address - Phone:704-563-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0103401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical