Provider Demographics
NPI:1235435959
Name:MONDOUX, ASHLEIGH (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:MONDOUX
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 HILL RD
Mailing Address - Street 2:
Mailing Address - City:ALSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03602-3213
Mailing Address - Country:US
Mailing Address - Phone:401-644-6538
Mailing Address - Fax:
Practice Address - Street 1:155 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3131
Practice Address - Country:US
Practice Address - Phone:401-644-6538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NH16771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical