Healthcare Provider Details

I. General information

NPI: 1407578586
Provider Name (Legal Business Name): ASHLEY LYNN HARWOOD LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 09/14/2022
Certification Date: 09/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 W 239TH ST
BRONX NY
10463-1205
US

IV. Provider business mailing address

147 W 130TH ST APT BF
NEW YORK NY
10027-2459
US

V. Phone/Fax

Practice location:
  • Phone: 718-601-2280
  • Fax:
Mailing address:
  • Phone: 704-490-9154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP117882
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: