Provider Demographics
NPI:1235619396
Name:SPELIOTIS, ASHLEY E (LICSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:E
Last Name:SPELIOTIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2453
Mailing Address - Country:US
Mailing Address - Phone:617-697-9910
Mailing Address - Fax:
Practice Address - Street 1:167 HOLLAND ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2401
Practice Address - Country:US
Practice Address - Phone:617-625-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA115557104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker