Provider Demographics
NPI:1639246085
Name:ASHLEY, THOMAS BENJAMIN (LCSW)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BENJAMIN
Last Name:ASHLEY
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 1:3515 WARNER AVE STE 565
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3727
Mailing Address - Country:US
Mailing Address - Phone:502-741-9219
Mailing Address - Fax:
Practice Address - Street 1:3515 WARNER AVE STE 565
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3727
Practice Address - Country:US
Practice Address - Phone:502-741-9219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO09927971041C0700X
KY14461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY82000233Medicaid
KYP15864Medicare UPIN
IN129930GMedicare ID - Type Unspecified
KY0576204Medicare ID - Type Unspecified