Provider Demographics
NPI:1538713128
Name:PROKOP, ASHLEY LAUREN (LAC, NCC, ATR-P)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:LAUREN
Last Name:PROKOP
Suffix:
Gender:F
Credentials:LAC, NCC, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1239 PARKWAY AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-3000
Mailing Address - Country:US
Mailing Address - Phone:609-394-5157
Mailing Address - Fax:
Practice Address - Street 1:1239 PARKWAY AVE STE 102
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-3000
Practice Address - Country:US
Practice Address - Phone:609-394-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00384100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health