Provider Demographics
NPI:1639635782
Name:HOMSTEAD, ASHLEY M (LCSW, LADC, CCS)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:HOMSTEAD
Suffix:
Gender:F
Credentials:LCSW, LADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ACME RD STE 207
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1546
Mailing Address - Country:US
Mailing Address - Phone:207-573-4722
Mailing Address - Fax:
Practice Address - Street 1:12 ACME RD STE 207
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1546
Practice Address - Country:US
Practice Address - Phone:207-573-4722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC6896101YA0400X
MEMC19083101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)