Provider Demographics
NPI:1700107919
Name:KRETZ, ASHLEI M (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEI
Middle Name:M
Last Name:KRETZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ASHLEI
Other - Middle Name:M
Other - Last Name:SPARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:743 HORIZON CT STE 220
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8716
Mailing Address - Country:US
Mailing Address - Phone:844-787-8721
Mailing Address - Fax:
Practice Address - Street 1:743 HORIZON CT STE 220
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8716
Practice Address - Country:US
Practice Address - Phone:844-787-8721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-084871041C0700X
NMX-082111041S0200X
COCSW099260391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool