Provider Demographics
NPI:1083124408
Name:RAY, ASHLEY (MSW, LISW, LICDC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:MSW, LISW, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2399 HOME RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1597
Mailing Address - Country:US
Mailing Address - Phone:740-610-3177
Mailing Address - Fax:
Practice Address - Street 1:524 W BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2775
Practice Address - Country:US
Practice Address - Phone:614-224-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.16008101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical