Provider Demographics
NPI:1699296624
Name:ELDRIDGE, ASHLEY (MSW, LCSW, LCAS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ELDRIDGE
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 CAROLINA BEACH RD STE 8-88
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2957
Mailing Address - Country:US
Mailing Address - Phone:910-777-5185
Mailing Address - Fax:910-782-4332
Practice Address - Street 1:6400 CAROLINA BEACH RD STE 8-88
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2957
Practice Address - Country:US
Practice Address - Phone:910-777-5185
Practice Address - Fax:910-782-4332
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC012992OtherNC SOCIAL WORK CERTIFICATION AND LICENSURE BOARD
NCLCAS-23744OtherNC ADDICTIONS SPECIALIST PROFESSIONAL PRACTICE BOARD
NCP011383OtherLICENSE