MEDICARE: MS. ASHLEY LYNETTE WITHERSPOON MSW LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW19178	FL
2	1041C0700X	Clinical Social Worker	C007964	NC

General Provider Information

NPI Number	:	1700137411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ASHLEY LYNETTE WITHERSPOON MSW LCSW

Provider Business Mailing Address
First Line	:	600 PARK OFFICES DR STE 300
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-2890
Country	:	US
Telephone Number	:	336-549-4878
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 BLUEBIRD CT
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-8139
Country	:	US
Telephone Number	:	336-549-4878
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2012
Last Update Date	:	03/24/2026

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