Provider Demographics
NPI:1669964227
Name:WITT, ASHLEY LOREN (CDCA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:LOREN
Last Name:WITT
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044
Mailing Address - Country:US
Mailing Address - Phone:513-727-1438
Mailing Address - Fax:
Practice Address - Street 1:2005 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044
Practice Address - Country:US
Practice Address - Phone:513-727-1438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.167330101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)