Healthcare Provider Details

I. General information

NPI: 1750290912
Provider Name (Legal Business Name): ASHLEY JORDAN MOLINA MSW, RCSWI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1522 PENMAN RD
JACKSONVILLE BEACH FL
32250-3744
US

IV. Provider business mailing address

5278 HOLLYCREST DR
JACKSONVILLE FL
32205-7021
US

V. Phone/Fax

Practice location:
  • Phone: 904-323-2729
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW22376
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: