Provider Demographics
NPI:1639545858
Name:WISE, ASHLEY (LCSW-A)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WISE
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 RICHMOND DR
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-5171
Mailing Address - Country:US
Mailing Address - Phone:864-909-9272
Mailing Address - Fax:
Practice Address - Street 1:198 BRITTANY PLACE DR
Practice Address - Street 2:APT W
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-7116
Practice Address - Country:US
Practice Address - Phone:864-909-9272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0095421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical