Healthcare Provider Details

I. General information

NPI: 1235058256
Provider Name (Legal Business Name): ASHLEY JAMISON LCSW-C, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11886 WINGED FOOT CT
WALDORF MD
20602-3261
US

IV. Provider business mailing address

11886 WINGED FOOT CT
WALDORF MD
20602-3261
US

V. Phone/Fax

Practice location:
  • Phone: 757-572-0696
  • Fax:
Mailing address:
  • Phone: 757-572-0696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC50080595
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: