Healthcare Provider Details

I. General information

NPI: 1134038607
Provider Name (Legal Business Name): ASHLEY NICOLE DELANCY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 FLOWOOD DR # A205
FLOWOOD MS
39232-9362
US

IV. Provider business mailing address

403 KNIGHTS CV W
BRANDON MS
39047-4444
US

V. Phone/Fax

Practice location:
  • Phone: 601-939-5993
  • Fax:
Mailing address:
  • Phone: 601-939-5993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-11984
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: