Healthcare Provider Details

I. General information

NPI: 1134888324
Provider Name (Legal Business Name): ASHLEY BURRELL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 9TH AVE SW STE 400
BESSEMER AL
35022-7841
US

IV. Provider business mailing address

67 SQUIRREL RD
AKRON AL
35441-2616
US

V. Phone/Fax

Practice location:
  • Phone: 205-428-3495
  • Fax:
Mailing address:
  • Phone: 214-543-5209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4871G
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: