Provider Demographics
NPI:1144661919
Name:BRISENTINE, ASHLEE ELIZABETH (LPC, MS)
Entity type:Individual
Prefix:MRS
First Name:ASHLEE
Middle Name:ELIZABETH
Last Name:BRISENTINE
Suffix:
Gender:F
Credentials:LPC, MS
Other - Prefix:MS
Other - First Name:ASHLEE
Other - Middle Name:ELIZABETH
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-5484
Mailing Address - Country:US
Mailing Address - Phone:541-729-1930
Mailing Address - Fax:541-393-9869
Practice Address - Street 1:500 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-5484
Practice Address - Country:US
Practice Address - Phone:541-238-5771
Practice Address - Fax:541-393-9869
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2023-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
ORC4243101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist