Provider Demographics
NPI:1063261667
Name:EDWARDS, ASHLEY (LICSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 N CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36107-1519
Mailing Address - Country:US
Mailing Address - Phone:404-805-3358
Mailing Address - Fax:
Practice Address - Street 1:23 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36107-1519
Practice Address - Country:US
Practice Address - Phone:404-805-3358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5655C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical