Provider Demographics
NPI:1053686360
Name:ASHWORTH PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:ASHWORTH PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:JANET ASHWORTH, PH.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:K
Authorized Official - Last Name:ASHWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-390-3411
Mailing Address - Street 1:3330 N. GALLOWAY AVE.
Mailing Address - Street 2:SUITE 304, BOX 17
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4728
Mailing Address - Country:US
Mailing Address - Phone:214-390-3411
Mailing Address - Fax:214-666-4208
Practice Address - Street 1:8344 E R L THORNTON FWY
Practice Address - Street 2:SUITE 410-B
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7136
Practice Address - Country:US
Practice Address - Phone:214-390-3411
Practice Address - Fax:214-666-4208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15755103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031318101Medicaid