Provider Demographics
NPI:1538755715
Name:HADEN-PEACHES, ASHLEY (LMSW, IBCLC, CD-DONA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HADEN-PEACHES
Suffix:
Gender:
Credentials:LMSW, IBCLC, CD-DONA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 N BELLEVIEW AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-1507
Mailing Address - Country:US
Mailing Address - Phone:913-703-3252
Mailing Address - Fax:816-295-2530
Practice Address - Street 1:4444 N BELLEVIEW AVE STE 204
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1507
Practice Address - Country:US
Practice Address - Phone:913-703-3252
Practice Address - Fax:816-295-2530
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8917104100000X
MO2013027633104100000X
L-306273174N00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490105559Medicaid
KS30005228240001Medicaid