Provider Demographics
NPI:1568834240
Name:NOTESTINE, ASHELY WELLS (LCPC 7410)
Entity Type:Individual
Prefix:MRS
First Name:ASHELY
Middle Name:WELLS
Last Name:NOTESTINE
Suffix:
Gender:F
Credentials:LCPC 7410
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 E POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3436
Mailing Address - Country:US
Mailing Address - Phone:208-717-1208
Mailing Address - Fax:
Practice Address - Street 1:122 E POPLAR AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-3436
Practice Address - Country:US
Practice Address - Phone:208-717-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC7410101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health