Provider Demographics
NPI:1134914211
Name:MAVRIKOS, ASHLEY (LADC)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:MAVRIKOS
Suffix:
Gender:
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 INDUSTRIAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03235-2507
Mailing Address - Country:US
Mailing Address - Phone:603-671-7045
Mailing Address - Fax:
Practice Address - Street 1:67 INDUSTRIAL PARK DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2507
Practice Address - Country:US
Practice Address - Phone:603-671-7045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1253101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)