Provider Demographics
NPI:1912545815
Name:STARWOOD, ASHLEY (LSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:STARWOOD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 E MAIN ST STE 1038
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2424
Mailing Address - Country:US
Mailing Address - Phone:630-474-4600
Mailing Address - Fax:630-474-4640
Practice Address - Street 1:13242 S ROUTE 59 STE 104
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-5438
Practice Address - Country:US
Practice Address - Phone:815-267-0380
Practice Address - Fax:630-797-9389
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.103927104100000X
IL149.0233221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker