Provider Demographics
NPI:1477162527
Name:TARRENCE, ASHLEY RENEE I (BA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:TARRENCE
Suffix:I
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2645 BEAVER DAM RD
Mailing Address - Street 2:
Mailing Address - City:LEITCHFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42754-9053
Mailing Address - Country:US
Mailing Address - Phone:270-899-2257
Mailing Address - Fax:855-859-1695
Practice Address - Street 1:409 MILLERSTOWN ST
Practice Address - Street 2:
Practice Address - City:CLARKSON
Practice Address - State:KY
Practice Address - Zip Code:42726-8146
Practice Address - Country:US
Practice Address - Phone:270-899-2257
Practice Address - Fax:855-859-1695
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator