Provider Demographics
NPI:1386523538
Name:CLEMENS, ASHLYN (LLC)
Entity type:Individual
Prefix:
First Name:ASHLYN
Middle Name:
Last Name:CLEMENS
Suffix:
Gender:F
Credentials:LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16495 F DR N
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-9618
Mailing Address - Country:US
Mailing Address - Phone:765-251-1252
Mailing Address - Fax:
Practice Address - Street 1:111 N JEFFERSON ST STE 7
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1553
Practice Address - Country:US
Practice Address - Phone:765-251-1252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-01
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024559101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty