Provider Demographics
NPI:1205197860
Name:USITA, ASHLEY LAFAYE LEOLANI (MA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LAFAYE LEOLANI
Last Name:USITA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:LAFAYE LEOLANI
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10775 PIONEER TRL STE 215
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-0234
Mailing Address - Country:US
Mailing Address - Phone:415-814-9604
Mailing Address - Fax:
Practice Address - Street 1:21212 119TH ST E APT 2
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-7729
Practice Address - Country:US
Practice Address - Phone:808-896-7829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60723564101YM0800X
HIMHC-401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health