Provider Demographics
NPI:1205103256
Name:COUNTRYMAN, ASHLEY E (MS, LCPC, LCAC)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:E
Last Name:COUNTRYMAN
Suffix:
Gender:F
Credentials:MS, LCPC, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 E 24TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-5338
Mailing Address - Country:US
Mailing Address - Phone:785-312-4417
Mailing Address - Fax:
Practice Address - Street 1:1629 E 24TH ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-5338
Practice Address - Country:US
Practice Address - Phone:785-312-4417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS121101YA0400X
KS732101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)