Provider Demographics
NPI:1437487253
Name:GINOBA, ASHLEY FOWLER (LCSW, LICSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:FOWLER
Last Name:GINOBA
Suffix:
Gender:F
Credentials:LCSW, LICSW, LCSW-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:LATRICE
Other - Last Name:FOWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:15343 INLET PL
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-5204
Mailing Address - Country:US
Mailing Address - Phone:336-214-0811
Mailing Address - Fax:
Practice Address - Street 1:901 N GLEBE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1853
Practice Address - Country:US
Practice Address - Phone:323-205-7088
Practice Address - Fax:833-419-0181
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP004597101Y00000X
VA09040115671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor