Provider Demographics
NPI:1164820981
Name:NOE, ASHLEY BROWNING PETERSON (LMSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BROWNING PETERSON
Last Name:NOE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7215 THORNCREST DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7358
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7215 THORNCREST DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7358
Practice Address - Country:US
Practice Address - Phone:616-443-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2628861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical