Provider Demographics
NPI:1639660491
Name:DOAN, ASHLEY (LICSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DOAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PARKMAN STREET
Mailing Address - Street 2:ACC037
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:570-439-4490
Mailing Address - Fax:617-726-1042
Practice Address - Street 1:15 PARKMAN STREET
Practice Address - Street 2:ACC037
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-643-4828
Practice Address - Fax:617-726-1042
Is Sole Proprietor?:No
Enumeration Date:2018-05-28
Last Update Date:2018-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1198171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical