Provider Demographics
NPI:1780808345
Name:ASHLEY, FEMITCHELL KEITH (MA)
Entity type:Individual
Prefix:MR
First Name:FEMITCHELL
Middle Name:KEITH
Last Name:ASHLEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 CHFRISTOPHER COLUMBUS DR.
Mailing Address - Street 2:304-B
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302
Mailing Address - Country:US
Mailing Address - Phone:201-333-7654
Mailing Address - Fax:
Practice Address - Street 1:19 WSET 34ST STREET
Practice Address - Street 2:PH-LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:917-881-9948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000441101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health