Basic Information
Provider Information
NPI: 1811401664
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARBER-BROWN
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
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Mailing Information
Address1: 284 EXECUTIVE PARK DR STE 100
Address2:  
City: CONCORD
State: NC
PostalCode: 280251833
CountryCode: US
TelephoneNumber: 7049391100
FaxNumber: 7049391173
Practice Location
Address1: 943 W ANDREWS AVE STE H
Address2:  
City: HENDERSON
State: NC
PostalCode: 275362562
CountryCode: US
TelephoneNumber: 2524330061
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/30/2017
LastUpdateDate: 07/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XA13496NCY193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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