Provider Demographics
NPI:1619040458
Name:ASHBAUGH, MICHELLE ANNETTE (ACSW LSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ANNETTE
Last Name:ASHBAUGH
Suffix:
Gender:F
Credentials:ACSW LSW
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:ANNETTE
Other - Last Name:KALP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACSW LSW
Mailing Address - Street 1:438 PELLIS ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601
Mailing Address - Country:US
Mailing Address - Phone:724-850-7448
Mailing Address - Fax:724-850-8143
Practice Address - Street 1:438 PELLIS ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-850-7448
Practice Address - Fax:724-850-8143
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW-011426-L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA383907OtherHIGHMARK BCBS