Provider Demographics
NPI:1063827137
Name:ROGERS, ASHLEE (LSW)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:2233 ROCKY LN
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-4701
Mailing Address - Country:US
Mailing Address - Phone:419-281-3716
Mailing Address - Fax:419-281-4605
Practice Address - Street 1:2233 ROCKY LN
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4701
Practice Address - Country:US
Practice Address - Phone:419-281-3716
Practice Address - Fax:419-281-4605
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0027616101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health