MEDICARE: ASHLEY STROUD LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	MSW007083	GA

General Provider Information

NPI Number	:	1962085530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY STROUD LMSW

Provider Business Mailing Address
First Line	:	722 COLLINS HILL RD STE H325
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30046-4118
Country	:	US
Telephone Number	:	404-314-6334
Fax Number	:

Provider Business Practice Location Address
First Line	:	5375 SUGARLOAF PKWY
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30043-5767
Country	:	US
Telephone Number	:	404-314-6334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2021
Last Update Date	:	05/03/2021

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Directions to “ ASHLEY STROUD LMSW” Practice Location

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