Provider Demographics
NPI:1063816924
Name:YOUNG, ASHLEY K (MS, BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:K
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS, BCBA, LABA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:K
Other - Last Name:ABBOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA, LABA
Mailing Address - Street 1:3 SAN JOSE DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-4618
Mailing Address - Country:US
Mailing Address - Phone:401-200-1125
Mailing Address - Fax:
Practice Address - Street 1:31 HILLER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02770-4024
Practice Address - Country:US
Practice Address - Phone:774-454-1994
Practice Address - Fax:508-273-2353
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110026265EMedicaid