Healthcare Provider Details

I. General information

NPI: 1962777284
Provider Name (Legal Business Name): AMBROSIA SPAULDING MSW, LCSW, LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 SPAULDING LN
CLARKTON NC
28433-6003
US

IV. Provider business mailing address

68 SPAULDING LN
CLARKTON NC
28433-6003
US

V. Phone/Fax

Practice location:
  • Phone: 910-302-8494
  • Fax: 910-679-6348
Mailing address:
  • Phone: 910-302-8494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC009552
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14711
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17186-132
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number117368
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS20725
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW19175
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11820-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: