Provider Demographics
NPI:1194700807
Name:ASHFORD, LAURA HADLEY THOMPSON (BSW, MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAURA HADLEY
Middle Name:THOMPSON
Last Name:ASHFORD
Suffix:
Gender:F
Credentials:BSW, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 DOCKERY LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-8314
Mailing Address - Country:US
Mailing Address - Phone:919-971-8732
Mailing Address - Fax:919-859-6363
Practice Address - Street 1:547 KEISLER DR
Practice Address - Street 2:SUITE 104
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-9309
Practice Address - Country:US
Practice Address - Phone:919-971-8732
Practice Address - Fax:919-859-6363
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0010231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12072OtherINDIVIDUAL
NC6002043Medicaid