Provider Demographics
NPI:1841766789
Name:ESTERLINE, ASHLEY ERIN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ERIN
Last Name:ESTERLINE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:ERIN
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2030 PORTAGE ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-3836
Mailing Address - Country:US
Mailing Address - Phone:269-568-7748
Mailing Address - Fax:
Practice Address - Street 1:2030 PORTAGE ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-3836
Practice Address - Country:US
Practice Address - Phone:269-568-7748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010993291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical