Provider Demographics
NPI:1689394595
Name:ERNEST, ALYSHA M (BS)
Entity Type:Individual
Prefix:
First Name:ALYSHA
Middle Name:M
Last Name:ERNEST
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-5343
Mailing Address - Country:US
Mailing Address - Phone:304-748-3768
Mailing Address - Fax:
Practice Address - Street 1:3920 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5343
Practice Address - Country:US
Practice Address - Phone:304-748-3768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor