Provider Demographics
NPI:1003271693
Name:BIRKHOLZ, ASHLEY ELIZABETH (CAPSW, SAC)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:BIRKHOLZ
Suffix:
Gender:F
Credentials:CAPSW, SAC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ELIZABETH
Other - Last Name:CZARNOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1990 WISCONSIN AVE STOP 2
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-2601
Mailing Address - Country:US
Mailing Address - Phone:262-421-7121
Mailing Address - Fax:
Practice Address - Street 1:1990 WISCONSIN AVE STOP 2
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-2601
Practice Address - Country:US
Practice Address - Phone:262-421-7121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16020-132101YA0400X
WI9063-123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)