Provider Demographics
NPI:1134383193
Name:SMITH, ASHLEY JUNE (PHD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:JUNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 OAK ST STE C
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-2266
Mailing Address - Country:US
Mailing Address - Phone:913-633-2587
Mailing Address - Fax:
Practice Address - Street 1:6155 OAK ST STE C
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64113-2266
Practice Address - Country:US
Practice Address - Phone:913-633-2587
Practice Address - Fax:913-649-8823
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLP1815103TB0200X
NE309103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical