Provider Demographics
NPI:1265635247
Name:ASHLEY, JANET (SOCIALWORKER)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:SOCIALWORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 CUNNINGHAM DRIVE
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-5665
Mailing Address - Country:US
Mailing Address - Phone:312-864-2288
Mailing Address - Fax:312-864-9143
Practice Address - Street 1:1265 CUNNINGHAM DR
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-5665
Practice Address - Country:US
Practice Address - Phone:312-864-2288
Practice Address - Fax:312-864-9143
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical