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General NPI Number Information
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NPI Number | 1730996570
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Entity Type | Individual
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Provider Name | ASHLEY TAMI-LYN COOLEY CMSW, LCSW-A
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Gender | Female
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 650 JOEL DR
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City | FORT CAMPBELL
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State | KY
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Zip | 42223-5318
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Country | US
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Telephone | 270-798-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 4109 REDSPIRE LN
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-9382
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Country | US
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Telephone | 603-275-9857
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Fax |
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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 | B001203
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P020926
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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