Provider Demographics
NPI:1295421782
Name:MERGENTHAL, ASHLEY SUE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SUE
Last Name:MERGENTHAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:SUE
Other - Last Name:LINKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8220 CHENEY RIDGE RD APT 118
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3810
Mailing Address - Country:US
Mailing Address - Phone:531-218-8573
Mailing Address - Fax:
Practice Address - Street 1:2320 S 48TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5515
Practice Address - Country:US
Practice Address - Phone:402-218-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician