Provider Demographics
NPI:1881465383
Name:FAISON, ASHLEY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:FAISON
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 1:2532 CHESTNUT LN
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-6780
Mailing Address - Country:US
Mailing Address - Phone:347-534-5799
Mailing Address - Fax:
Practice Address - Street 1:855 E 7TH ST APT 5M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2224
Practice Address - Country:US
Practice Address - Phone:347-534-5799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0777901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical