MEDICARE: ASHLEY DENISE GAMBLE 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	34011656A	IN
2	1041C0700X	Clinical Social Worker	CSW009671	GA

General Provider Information

NPI Number	:	1962135442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY DENISE GAMBLE MSW, LCSW

Provider Business Mailing Address
First Line	:	400 BELMONT PL SE UNIT 1109
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-1971
Country	:	US
Telephone Number	:	404-399-9184
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 BIG HAYNES CT
Second Line	:
City	:	GRAYSON
State	:	GA
Zip	:	30017-1292
Country	:	US
Telephone Number	:	470-670-6030
Fax Number	:

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

Provider Enumeration Date	:	07/02/2022
Last Update Date	:	06/20/2026

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