Provider Demographics
NPI:1982031100
Name:POLK, ASHLEY (LPC)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:
Last Name:POLK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 NW 43RD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-5027
Mailing Address - Country:US
Mailing Address - Phone:816-385-3751
Mailing Address - Fax:
Practice Address - Street 1:1415 NW 43RD ST STE 101
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-5027
Practice Address - Country:US
Practice Address - Phone:816-385-3751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health