Provider Demographics
NPI:1467145573
Name:PRIVRATSKY, ASHLYN ROSE (LMSW)
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:ROSE
Last Name:PRIVRATSKY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12575 45TH ST SW
Mailing Address - Street 2:
Mailing Address - City:BELFIELD
Mailing Address - State:ND
Mailing Address - Zip Code:58622-9225
Mailing Address - Country:US
Mailing Address - Phone:701-690-8284
Mailing Address - Fax:
Practice Address - Street 1:1679 6TH AVE W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-2904
Practice Address - Country:US
Practice Address - Phone:701-483-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6526104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker