Provider Demographics
NPI:1154303238
Name:ASHBY, JANELLE WARNER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:WARNER
Last Name:ASHBY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:SHIPSHEWANA
Mailing Address - State:IN
Mailing Address - Zip Code:46565-0414
Mailing Address - Country:US
Mailing Address - Phone:260-336-3362
Mailing Address - Fax:260-768-7114
Practice Address - Street 1:245 N. MORTON
Practice Address - Street 2:
Practice Address - City:SHIPSHEWANA
Practice Address - State:IN
Practice Address - Zip Code:46565
Practice Address - Country:US
Practice Address - Phone:260-336-3362
Practice Address - Fax:260-768-7114
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041285A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000388789OtherANTHEM
IN200176640BMedicaid
IN234600AMedicare PIN
INS00038Medicare UPIN