Provider Demographics
NPI:1942425269
Name:DAVIS, ASHLEY S (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:S
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3921
Mailing Address - Country:US
Mailing Address - Phone:303-919-4149
Mailing Address - Fax:
Practice Address - Street 1:530 CONCORD AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3921
Practice Address - Country:US
Practice Address - Phone:303-919-4149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COUNKNOWN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health