Provider Demographics
NPI:1952761124
Name:NANCY ASHWORTH MSW
Entity Type:Organization
Organization Name:NANCY ASHWORTH MSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELING/PSYCHOTHERAPY
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ASHWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:908-642-8547
Mailing Address - Street 1:450 AMWELL RD
Mailing Address - Street 2:2ND FLOOR-SUITE LIFE #6
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1218
Mailing Address - Country:US
Mailing Address - Phone:908-642-8547
Mailing Address - Fax:
Practice Address - Street 1:450 AMWELL RD
Practice Address - Street 2:2ND FLOOR-SUITE LIFE #6
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1218
Practice Address - Country:US
Practice Address - Phone:908-642-8547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NANCY ASHWORTH MSW,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001443001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ675449PSYOtherMEDICARE