Individual provider Active NPI

Ashley Nicole Famularo, LCSW

  • Clinical Social Worker
  • Augusta, GA
National Provider Identifier
1467119222
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW23784 Issued in FL
Practice address
Fort Gordon
Augusta, GA 30905
Phone
(813) 308-9264
NPI assigned
Nov 29, 2021
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW23784 FL Primary

Addresses

Primary practice location

Fort Gordon
Augusta, GA 30905

Mailing address

5004 W Lancaster St
Tampa, FL 33616-1301

Other names 1

  • Ms. Ashley Nicole Famularo Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625003701 FL Practitioner - Clinical Social Worker 3678085487 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW17976FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince May 16, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1467119222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5004 W LANCASTER ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336161301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FORT GORDON",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30905",
            "telephone_number": "813-308-9264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMULARO",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW23784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "FAMULARO",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.