Provider Demographics
NPI:1841646239
Name:KIEFER, ASHLEY K (LCSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:K
Last Name:KIEFER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:39 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06779-1418
Mailing Address - Country:US
Mailing Address - Phone:203-815-9432
Mailing Address - Fax:
Practice Address - Street 1:2030 STRAITS TPKE
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1831
Practice Address - Country:US
Practice Address - Phone:203-558-1143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1145104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker