Provider Demographics
NPI:1407189855
Name:ASH, JAYNE ANN (LMHC)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:ANN
Last Name:ASH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 RACETRACK RD
Mailing Address - Street 2:
Mailing Address - City:ARENAS VALLEY
Mailing Address - State:NM
Mailing Address - Zip Code:88022-9712
Mailing Address - Country:US
Mailing Address - Phone:575-534-9144
Mailing Address - Fax:
Practice Address - Street 1:88 RACETRACK RD
Practice Address - Street 2:
Practice Address - City:ARENAS VALLEY
Practice Address - State:NM
Practice Address - Zip Code:88022-9712
Practice Address - Country:US
Practice Address - Phone:575-534-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0103411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health