Provider Demographics
NPI:1457188427
Name:MILAM, ASHLEIGH JAN (LCSW)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:JAN
Last Name:MILAM
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4757 W PARK BLVD STE 113
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-2329
Mailing Address - Country:US
Mailing Address - Phone:214-997-3371
Mailing Address - Fax:
Practice Address - Street 1:18880 MARSH LN APT 1809
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-2239
Practice Address - Country:US
Practice Address - Phone:972-880-7485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
1080791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker