Organization Active NPI

Lead Freely Licensed Clinical Social Worker Professional Corporation

  • Clinical Social Worker
  • Birmingham, AL
National Provider Identifier
1033053681
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LEAD FREELY LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION
Practice address
2008 3Rd Ave N
Birmingham, AL 35203-3332
Phone
(205) 899-4000
NPI assigned
Apr 15, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashley Geneva Walay, LCSWNPI 1013634666
Title
Authorized Official
Phone
(510) 457-1004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2008 3Rd Ave N
Birmingham, AL 35203-3332

Mailing address

3964 Rivermark PLZ Ste 2743
Santa Clara, CA 95054-4155
Phone (510) 457-1004

National Provider Directory

National Provider Directory

Locations

3964 Rivermark Plz
Santa Clara, CA 95054
Phone (408) 242-0912

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1033053681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3964 RIVERMARK PLZ STE 2743",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950544155",
            "telephone_number": "510-457-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 3RD AVE N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352033332",
            "telephone_number": "205-899-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAD FREELY LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-15",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "WALAY",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "GENEVA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "510-457-1004",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.