Provider Demographics
NPI:1114108602
Name:HAGEN, ASHLIE LAINE (MS, LMHC)
Entity Type:Individual
Prefix:MS
First Name:ASHLIE
Middle Name:LAINE
Last Name:HAGEN
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-3502
Mailing Address - Country:US
Mailing Address - Phone:509-744-1117
Mailing Address - Fax:509-744-3055
Practice Address - Street 1:1404 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-3502
Practice Address - Country:US
Practice Address - Phone:509-744-1117
Practice Address - Fax:509-744-3055
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health