Provider Demographics
NPI:1073985131
Name:CHARBONNEAU, ASHLEY FRANCES (LCSW, LAC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:FRANCES
Last Name:CHARBONNEAU
Suffix:
Gender:F
Credentials:LCSW, LAC
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:FRANCES
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16082 CLAYTON ST
Mailing Address - Street 2:
Mailing Address - City:THORON
Mailing Address - State:CO
Mailing Address - Zip Code:80202
Mailing Address - Country:US
Mailing Address - Phone:970-319-7986
Mailing Address - Fax:
Practice Address - Street 1:16082 CLAYTON ST
Practice Address - Street 2:
Practice Address - City:THORON
Practice Address - State:CO
Practice Address - Zip Code:80202
Practice Address - Country:US
Practice Address - Phone:970-319-7986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW99205171041C0700X
COCSW.099242701041C0700X
COACD.0001517101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19312521Medicaid