Provider Demographics
NPI:1598787921
Name:ASHBAUGH, TANYA ADAIR (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:ADAIR
Last Name:ASHBAUGH
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 1:4640 BEMUS ELLERY RD
Mailing Address - Street 2:
Mailing Address - City:BEMUS POINT
Mailing Address - State:NY
Mailing Address - Zip Code:14712-9417
Mailing Address - Country:US
Mailing Address - Phone:716-366-2122
Mailing Address - Fax:716-366-6455
Practice Address - Street 1:319 CENTRAL AVE STE B
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2137
Practice Address - Country:US
Practice Address - Phone:716-363-6050
Practice Address - Fax:716-363-6851
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066083-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical