Provider Demographics
NPI:1760093918
Name:ASHBURN, ANNA R (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:R
Last Name:ASHBURN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6207 SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1060
Mailing Address - Country:US
Mailing Address - Phone:737-704-4234
Mailing Address - Fax:512-334-4465
Practice Address - Street 1:6207 SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1060
Practice Address - Country:US
Practice Address - Phone:737-704-4234
Practice Address - Fax:512-334-4465
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TX696571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator