Provider Demographics
NPI:1356796304
Name:SIEPKA, ASHLEY NICOLE (MSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:SIEPKA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:61031-9768
Mailing Address - Country:US
Mailing Address - Phone:815-562-3801
Mailing Address - Fax:
Practice Address - Street 1:1321 N 7TH ST
Practice Address - Street 2:
Practice Address - City:ROCHELLE
Practice Address - State:IL
Practice Address - Zip Code:61068-1185
Practice Address - Country:US
Practice Address - Phone:815-562-3801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker