Provider Demographics
NPI:1700940038
Name:STOICK, ASHLEY (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:
Last Name:STOICK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-1537
Mailing Address - Country:US
Mailing Address - Phone:989-673-6191
Mailing Address - Fax:989-672-3170
Practice Address - Street 1:323 N STATE ST
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-1537
Practice Address - Country:US
Practice Address - Phone:989-673-6191
Practice Address - Fax:989-672-3170
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801087749104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI730195Medicaid
MI382143740OtherSTATE FED ID NUMBER
MI0G36205Medicare ID - Type Unspecified