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General NPI Number Information
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NPI Number | 1043515174
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Entity Type | Individual
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Provider Name | ASHLEY CLARK COMEGYS LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 11232 BOYETTE RD # 1021
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City | RIVERVIEW
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State | FL
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Zip | 33569-8009
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Country | US
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Telephone | 504-534-5636
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Fax |
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Provider Business Mailing Address
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Address Line | 3575 BRIDGE RD STE 8
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City | SUFFOLK
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State | VA
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Zip | 23435-1800
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Country | US
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Telephone | 504-534-5636
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Fax | 504-230-0380
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 11180
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09926420
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 18752
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904017935
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4075
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License Number State | HI
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11180
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License Number State | LA
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