Provider Demographics
NPI:1851827836
Name:STOCK, ASHLEY KURZ (LISW-S)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KURZ
Last Name:STOCK
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 W 32ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-4018
Mailing Address - Country:US
Mailing Address - Phone:216-651-5982
Mailing Address - Fax:216-651-0112
Practice Address - Street 1:2050 W 32ND ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113
Practice Address - Country:US
Practice Address - Phone:216-651-5982
Practice Address - Fax:216-651-0112
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1000218-SUPV104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker