Provider Demographics
NPI:1780835041
Name:KLINGELSMITH, ASHLEY N (MED, PCC-S, IMFT-S)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:KLINGELSMITH
Suffix:
Gender:F
Credentials:MED, PCC-S, IMFT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 W COMET RD
Mailing Address - Street 2:
Mailing Address - City:NEW FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44216-9601
Mailing Address - Country:US
Mailing Address - Phone:330-705-3073
Mailing Address - Fax:
Practice Address - Street 1:1303 W MAPLE ST STE 102
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-2858
Practice Address - Country:US
Practice Address - Phone:330-705-3073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF.1500026106H00000X
OHE.0700438101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist