Provider Demographics
NPI:1811648553
Name:ELMQUIST, ASHLEY BEARDEN (EDS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BEARDEN
Last Name:ELMQUIST
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:KRYSTAL
Other - Last Name:BEARDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1125 MCCHESNEY AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-2726
Mailing Address - Country:US
Mailing Address - Phone:256-572-4051
Mailing Address - Fax:
Practice Address - Street 1:134 FRIERSON ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4603
Practice Address - Country:US
Practice Address - Phone:615-601-1256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health