# LEAD FREELY LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033053681
- **Authorized official:** ASHLEY GENEVA WALAY LCSW (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (510) 457-1004

## Contact information

- **Practice address:** 2008 3RD AVE N, BIRMINGHAM, AL 35203-3332
- **Practice address phone:** (205) 899-4000
- **Mailing address:** 3964 RIVERMARK PLZ STE 2743, SANTA CLARA, CA 95054-4155
- **Mailing address phone:** (510) 457-1004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2026
- **Last updated:** 04/15/2026