Provider Demographics
NPI:1598144594
Name:WARDLAW, ASHLEY ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANNE
Last Name:WARDLAW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:A
Other - Last Name:WARDLAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GRAHAM
Mailing Address - Street 1:91 W COLT SQUARE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:91 W COLT SQUARE DR STE 1
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2846
Practice Address - Country:US
Practice Address - Phone:479-684-8998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9820-C1041C0700X, 104100000X
AR9820101YM0800X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health