Provider Demographics
NPI:1942461389
Name:ASTON, AMY J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:J
Last Name:ASTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-0579
Mailing Address - Country:US
Mailing Address - Phone:817-579-1606
Mailing Address - Fax:817-579-1654
Practice Address - Street 1:416 S MORGAN ST
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-1958
Practice Address - Country:US
Practice Address - Phone:817-579-1606
Practice Address - Fax:817-579-1654
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX312541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196948703Medicaid
TX196948703Medicaid