Provider Demographics
NPI:1023796398
Name:KONDRACKI, ASHLEY ROSE (LPC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ROSE
Last Name:KONDRACKI
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 1:2191 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5927
Mailing Address - Country:US
Mailing Address - Phone:732-595-7874
Mailing Address - Fax:
Practice Address - Street 1:2191 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5927
Practice Address - Country:US
Practice Address - Phone:908-377-9942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00748300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional