Provider Demographics
NPI:1093552648
Name:KASPER, ASHLEY (LLMSW, BSW, BS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KASPER
Suffix:
Gender:X
Credentials:LLMSW, BSW, BS
Other - Prefix:
Other - First Name:ASH
Other - Middle Name:
Other - Last Name:KASPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLMSW, BSW, BS
Mailing Address - Street 1:215 WOODSBORO DR UPPR UNIT
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1386
Mailing Address - Country:US
Mailing Address - Phone:906-430-0004
Mailing Address - Fax:
Practice Address - Street 1:12703 W. 7 MILD RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-694-3886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511183481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical