Provider Demographics
NPI:1902333222
Name:PECINA, ASHLEY ROSE (LSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ROSE
Last Name:PECINA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 COLLINGWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43610-1173
Mailing Address - Country:US
Mailing Address - Phone:419-255-8585
Mailing Address - Fax:
Practice Address - Street 1:701 JEFFERSON AVE STE 101
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-6956
Practice Address - Country:US
Practice Address - Phone:419-283-7139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-17
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161204101YA0400X
OHS.19042301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)