Provider Demographics
NPI:1144591223
Name:DENHAM, ASHLEY M (LMSW-CC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:DENHAM
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 STILLWATER AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3500
Mailing Address - Country:US
Mailing Address - Phone:207-299-1414
Mailing Address - Fax:207-947-6278
Practice Address - Street 1:444 STILLWATER AVE STE 204
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3500
Practice Address - Country:US
Practice Address - Phone:207-299-1414
Practice Address - Fax:207-947-6278
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC133011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical