Provider Demographics
NPI:1093396475
Name:HORTON, ASHYLE NOELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHYLE
Middle Name:NOELLE
Last Name:HORTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5242 S HYDE PARK BLVD APT 913
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4255
Mailing Address - Country:US
Mailing Address - Phone:913-221-2073
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE STE 704
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3905
Practice Address - Country:US
Practice Address - Phone:312-715-8234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-18
Last Update Date:2021-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0230821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty