Provider Demographics
NPI:1629047741
Name:AINSWORTH, WILLIAM ROSS (LPC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ROSS
Last Name:AINSWORTH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 FRANKLIN STREET
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057
Mailing Address - Country:US
Mailing Address - Phone:724-794-1404
Mailing Address - Fax:724-794-1404
Practice Address - Street 1:164 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-1245
Practice Address - Country:US
Practice Address - Phone:724-794-1404
Practice Address - Fax:724-794-1804
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2436101YA0400X
PAPC001270101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001488360OtherHIGHMARK BLUE CROSS BLUE
PA1009378620001Medicaid
PA188688OtherVALUE OPTIONS AND VALUE
PA1009378620003Medicaid