Healthcare Provider Details

I. General information

NPI: 1598495764
Provider Name (Legal Business Name): ASHLEY BROOKE ANDERSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2022
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 WHITESVILLE RD STE A
TOMS RIVER NJ
08753-4105
US

IV. Provider business mailing address

21 NOTTINGHAM DR
HOWELL NJ
07731-1816
US

V. Phone/Fax

Practice location:
  • Phone: 732-504-3527
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number44SC06540800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06540800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number44SC06540800
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number44SC06540800
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number44SC06540800
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number44SC06540800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: