Provider Demographics
NPI:1194534495
Name:BRIDGEWATER, ASHLYN TAYLOR (LCSWA)
Entity type:Individual
Prefix:
First Name:ASHLYN
Middle Name:TAYLOR
Last Name:BRIDGEWATER
Suffix:
Gender:
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 1/2 PINE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4416
Mailing Address - Country:US
Mailing Address - Phone:317-869-8178
Mailing Address - Fax:
Practice Address - Street 1:6 1/2 PINE GROVE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4416
Practice Address - Country:US
Practice Address - Phone:317-869-8178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-02
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NCP0217291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical