Basic Information
Provider Information
NPI: 1003154451
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WINDSOR
FirstName: ASHIRA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: MSW, LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1601 30TH AVE
Address2:  
City: GULFPORT
State: MS
PostalCode: 395012741
CountryCode: US
TelephoneNumber: 2282842644
FaxNumber: 8554022013
Practice Location
Address1: 1520 29TH AVE STE 36
Address2:  
City: GULFPORT
State: MS
PostalCode: 395012843
CountryCode: US
TelephoneNumber: 2282842644
FaxNumber: 8554022013
Other Information
ProviderEnumerationDate: 01/18/2013
LastUpdateDate: 12/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health
104100000X  N Behavioral Health & Social Service ProvidersSocial Worker 

ID Information
IDTypeStateIssuerDescription
56CC01CAASPIRAOTHER


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