Healthcare Provider Details

I. General information

NPI: 1790698520
Provider Name (Legal Business Name): ASHLAY A DOUGLAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4874 CHARMES CT
NEW ORLEANS LA
70129-1506
US

IV. Provider business mailing address

4874 CHARMES CT
NEW ORLEANS LA
70129-1506
US

V. Phone/Fax

Practice location:
  • Phone: 504-221-5003
  • Fax:
Mailing address:
  • Phone: 504-221-5003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13702
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: