Provider Demographics
NPI:1093953507
Name:SEVILLE, ASHLEY RENE (BSSW, LSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENE
Last Name:SEVILLE
Suffix:
Gender:F
Credentials:BSSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 NORTHLAND BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4911
Mailing Address - Country:US
Mailing Address - Phone:513-771-7239
Mailing Address - Fax:
Practice Address - Street 1:270 NORTHLAND BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4911
Practice Address - Country:US
Practice Address - Phone:513-771-7239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS 0800346104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker