Provider Demographics
NPI:1265916357
Name:KUSSMAN, ASHLEY B (LPC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:B
Last Name:KUSSMAN
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 1:428 S POST RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3212
Mailing Address - Country:US
Mailing Address - Phone:718-744-8617
Mailing Address - Fax:
Practice Address - Street 1:22 GORDON AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-1033
Practice Address - Country:US
Practice Address - Phone:609-844-0452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00596100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional