Provider Demographics
NPI:1780311233
Name:ASHTON THERAPEUTICS PLLC
Entity type:Organization
Organization Name:ASHTON THERAPEUTICS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ASHTON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LCSW, MHP
Authorized Official - Phone:206-595-4319
Mailing Address - Street 1:350 SOUTHBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-2794
Mailing Address - Country:US
Mailing Address - Phone:206-414-9022
Mailing Address - Fax:
Practice Address - Street 1:350 SOUTHBRIDGE ST
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-2794
Practice Address - Country:US
Practice Address - Phone:206-414-9022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty