Provider Demographics
NPI:1205266418
Name:SROKOWSKI SHAFER, ASHLEY (MED LPCC-S)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:SROKOWSKI SHAFER
Suffix:
Gender:F
Credentials:MED LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3447 GRANTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-2971
Mailing Address - Country:US
Mailing Address - Phone:404-225-6729
Mailing Address - Fax:
Practice Address - Street 1:1 AKRON GENERAL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2432
Practice Address - Country:US
Practice Address - Phone:330-344-1559
Practice Address - Fax:303-344-5802
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1200276-CR101YP2500X
OHE.1700150-SUPV101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional