Provider Demographics
NPI:1699027474
Name:KASSON, ASHLEY A (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:KASSON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 4TH ST E STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-3082
Mailing Address - Country:US
Mailing Address - Phone:701-552-6573
Mailing Address - Fax:
Practice Address - Street 1:3220 4TH ST E STE 102
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3082
Practice Address - Country:US
Practice Address - Phone:701-552-6573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND054517Medicaid