Provider Demographics
NPI:1487005500
Name:ROLLEY, ASHLEY M (LSW, MSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:ROLLEY
Suffix:
Gender:F
Credentials:LSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 W WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1866
Mailing Address - Country:US
Mailing Address - Phone:330-787-9180
Mailing Address - Fax:
Practice Address - Street 1:7191 N LIMA RD
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3749
Practice Address - Country:US
Practice Address - Phone:330-501-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1100417104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker