Provider Demographics
NPI:1689771974
Name:ASHLEY, NORINE ELLA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NORINE
Middle Name:ELLA
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:IL
Mailing Address - Zip Code:62656-8100
Mailing Address - Country:US
Mailing Address - Phone:217-735-5581
Mailing Address - Fax:
Practice Address - Street 1:1096 1350TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:IL
Practice Address - Zip Code:62656-5094
Practice Address - Country:US
Practice Address - Phone:217-735-5581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007419103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical