Provider Demographics
NPI:1669020905
Name:DEHN, ASHLEY SABBATH (LPC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SABBATH
Last Name:DEHN
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 1:127 W PRAIRIE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:IL
Mailing Address - Zip Code:61085-9291
Mailing Address - Country:US
Mailing Address - Phone:815-990-7463
Mailing Address - Fax:
Practice Address - Street 1:1090 MCCONNELL RD
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-7310
Practice Address - Country:US
Practice Address - Phone:815-575-9675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.013477101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional