Provider Demographics
NPI:1851850309
Name:KIMBROUGH, ASHLEY (LICSW-S;PIP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KIMBROUGH
Suffix:
Gender:F
Credentials:LICSW-S;PIP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:MOTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW-S;PIP
Mailing Address - Street 1:108 ALF KING RD
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:AL
Mailing Address - Zip Code:35585-3643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 CHURCH ST NE STE 5&6
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-2472
Practice Address - Country:US
Practice Address - Phone:256-274-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2024-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4092G104100000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker