Provider Demographics
NPI:1689455370
Name:ONG, ASHLEY PHOUNG-TRINH (PC-IT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:PHOUNG-TRINH
Last Name:ONG
Suffix:
Gender:F
Credentials:PC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1526
Mailing Address - Country:US
Mailing Address - Phone:262-637-8888
Mailing Address - Fax:262-637-0695
Practice Address - Street 1:1519 E WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-2615
Practice Address - Country:US
Practice Address - Phone:262-547-2463
Practice Address - Fax:262-547-8002
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7498-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health