Provider Demographics
NPI:1164155354
Name:FENNELL, ASHLEY R (MA, LPCC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:R
Last Name:FENNELL
Suffix:
Gender:F
Credentials:MA, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-3323
Mailing Address - Country:US
Mailing Address - Phone:720-580-1340
Mailing Address - Fax:833-354-0461
Practice Address - Street 1:4625 E IOWA AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3811
Practice Address - Country:US
Practice Address - Phone:720-580-1340
Practice Address - Fax:833-354-0461
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0018821101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional