Healthcare Provider Details

I. General information

NPI: 1740079581
Provider Name (Legal Business Name): ASHTON SHARITA GILBERT LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 S REILLY RD
FAYETTEVILLE NC
28314-1825
US

IV. Provider business mailing address

6527 HIDDEN LAKE LOOP APT 95
FAYETTEVILLE NC
28304-0303
US

V. Phone/Fax

Practice location:
  • Phone: 910-491-6356
  • Fax: 910-491-8128
Mailing address:
  • Phone: 336-898-0355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP021504
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: