Provider Demographics
NPI:1801473897
Name:WHEAT, ASHLAND NICHOLE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:ASHLAND
Middle Name:NICHOLE
Last Name:WHEAT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47842-7069
Mailing Address - Country:US
Mailing Address - Phone:812-201-6299
Mailing Address - Fax:
Practice Address - Street 1:301 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IN
Practice Address - Zip Code:47842-2407
Practice Address - Country:US
Practice Address - Phone:812-201-6299
Practice Address - Fax:317-659-7855
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3500198A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN85000422AMedicaid