Healthcare Provider Details

I. General information

NPI: 1831951086
Provider Name (Legal Business Name): ASHLEY NICOLE IRISH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2423 SW 147TH AVE # 2130
MIAMI FL
33185-4082
US

IV. Provider business mailing address

2423 SW 147TH AVE # 2130
MIAMI FL
33185-4082
US

V. Phone/Fax

Practice location:
  • Phone: 786-885-2130
  • Fax:
Mailing address:
  • Phone: 786-885-2130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: