Provider Demographics
NPI:1336578194
Name:WOODS, ASHLEY E (LCSW, CCS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:E
Last Name:WOODS
Suffix:
Gender:F
Credentials:LCSW, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 STATE HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-8816
Mailing Address - Country:US
Mailing Address - Phone:887-421-8263
Mailing Address - Fax:
Practice Address - Street 1:35 STATE HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-8816
Practice Address - Country:US
Practice Address - Phone:877-421-8263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC177911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical