Organization
LEAD FREELY LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY GENEVA WALAY LCSW (AUTHORIZED OFFICIAL)
(510) 457-1004
Entity
Organization
Contact information
Practice address
2008 3RD AVE N, BIRMINGHAM, AL 35203-3332
(205) 899-4000
Mailing address
3964 RIVERMARK PLZ STE 2743, SANTA CLARA, CA 95054-4155
(510) 457-1004
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/15/2026
Last updated
04/15/2026
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